Healthcare Provider Details

I. General information

NPI: 1861589780
Provider Name (Legal Business Name): OMAHA EYECARE
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 10/10/2006
Last Update Date: 02/21/2008
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2730 S 114TH ST
OMAHA NE
68144-4712
US

IV. Provider business mailing address

2730 S 114TH ST
OMAHA NE
68144-4712
US

V. Phone/Fax

Practice location:
  • Phone: 402-333-2244
  • Fax: 402-333-5528
Mailing address:
  • Phone: 402-333-2244
  • Fax: 402-333-5528

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code152WC0802X
TaxonomyCorneal and Contact Management Optometrist
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code152WL0500X
TaxonomyLow Vision Rehabilitation Optometrist
License Number
License Number State
# 3
Primary TaxonomyN
Taxonomy Code152WP0200X
TaxonomyPediatric Optometrist
License Number
License Number State
# 4
Primary TaxonomyN
Taxonomy Code152WS0006X
TaxonomySports Vision Optometrist
License Number
License Number State
# 5
Primary TaxonomyN
Taxonomy Code152WX0102X
TaxonomyOccupational Vision Optometrist
License Number
License Number State
# 6
Primary TaxonomyY
Taxonomy Code152W00000X
TaxonomyOptometrist
License Number
License Number State

VIII. Authorized Official

Name: DR. COREY MICHAEL LANGFORD
Title or Position: OWNER
Credential: O.D.
Phone: 402-333-2244