MEDICARE: EYELOOKGOOD LLC

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	156FX1800X	Optician

General Provider Information

NPI Number	:	1831869932
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	EYELOOKGOOD LLC

Provider Business Mailing Address
First Line	:	PO BOX 63
Second Line	:
City	:	WAUNETA
State	:	NE
Zip	:	69045-0063
Country	:	US
Telephone Number	:	308-394-5111
Fax Number	:	308-394-5111

Provider Business Practice Location Address
First Line	:	308 N TECUMSEH STE 2
Second Line	:
City	:	WAUNETA
State	:	NE
Zip	:	69045-9501
Country	:	US
Telephone Number	:	308-394-5111
Fax Number	:	308-394-5111

Authorized Official
Title or Position	:	OWNER
Name	:	MRS. KAREN KAY ALLEN
Credential	:
Telephone Number	:	308-394-5111

Provider Enumeration Date	:	09/20/2021
Last Update Date	:	09/25/2021

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Directions to “EYELOOKGOOD LLC ” Practice Location

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