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ILLUSIONS EYEWEAR LLC NPI 1134252711


NPI Information

NPI: 1134252711
Provider Name: ILLUSIONS EYEWEAR LLC
Classification: Eyewear Supplier - 332H00000X
Entity Type: Organization
Address:
8616 N 30TH ST
OMAHA, NE
ZIP 68112
Phone: (402) 451-1717
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ILLUSIONS EYEWEAR LLC is an eyewear supplier in Omaha, NE. The provider is an organization that provides spectacles, contact lenses, and other vision enhancement devices prescribed by an optometrist or ophthalmologist. ILLUSIONS EYEWEAR LLC NPI is 1134252711. The provider is registered as an organization entity type and is a multiple single specialty group.

The provider's business location address is:

8616 N 30TH ST
OMAHA, NE
ZIP 68112-808
Phone: (402) 451-1717
Fax: (402) 451-3469

The provider's authorized official is Tommie Lee Blan .
The authorized official title is Optician Owner and has the following contact phone number (402) 451-1717.

The enumeration date for this NPI number is 3/13/2007 and was last updated on 6/11/2008.


Taxonomy Codes

The NPI record includes the healthcare provider taxonomy classification, state license number and state of licensure. The following information regarding the scope of practice of this provider is available:

No.Taxonomy CodeTaxonomy ClasificationTaxonomy SpecializationLicense NumberLicense StatePrimary
1152W00000XOptometristNo
2332H00000XEyewear SupplierYes

Other Identifiers

The following information regarding additional identifiers associated to this NPI record includes the other identifier number, identifier type, identifier state and issuer.

No.Other Provider IdentifierOther Provider Identifier TypeOther Provider Identifier StateOther Provider Identifier Issuer
1NA1057OTHERPTAN
2017542MEDICAIDNEBRASKA
310025369100MEDICAIDNEBRASKA

What is NPI?

NPI stands for National Provider Identifier. The NPI is a 10-digit identification number that is completely unique. The NPI number by itself does not contain any identifiable information such as a provider’s speciality or location. The NPI is assigned to individuals or organizacions for their lifespan and it is independent of key provider information type updates like a change of practices, location or speciality.

This page was last updated on: 11/14/2023

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