Healthcare Provider Details

I. General information

NPI: 1891024717
Provider Name (Legal Business Name): ELEGANT OPTICS CONTACTS & FAMILY EYE LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 12/24/2009
Last Update Date: 05/06/2011
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

6900 O STREET SUITE 127
LINCOLN NE
68510-2460
US

IV. Provider business mailing address

6900 O STREET SUITE 127
LINCOLN NE
68510-2460
US

V. Phone/Fax

Practice location:
  • Phone: 402-466-4111
  • Fax:
Mailing address:
  • Phone: 402-466-4111
  • Fax: 402-466-4202

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code261QM2500X
TaxonomyMedical Specialty Clinic/Center
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code332B00000X
TaxonomyDurable Medical Equipment & Medical Supplies
License Number
License Number State
# 3
Primary TaxonomyN
Taxonomy Code332H00000X
TaxonomyEyewear Supplier
License Number
License Number State

VIII. Authorized Official

Name: SHEILA FRANKS
Title or Position: OFFICE MANAGER
Credential:
Phone: 402-466-4111