Lake Avenue Eyecare Llc is a
Eyewear Supplier based in Gothenburg, Nebraska. Lake Avenue Eyecare Llc is licensed to practice in Nebraska (license number 1166) and their current practice location is
829 Lake Ave, Gothenburg, Nebraska. It can be reached at their office (for appointments etc.) via phone at
(308) 537-3390.
NPI number for Lake Avenue Eyecare Llc is 1396932430 and their current mailing address is 829 Lake Ave, Gothenburg, Nebraska. Lake Avenue Eyecare Llc
does not participate in medicare program and thus does not accept medicare assignments. The facility's NPI Number is 1396932430.
Healthcare Provider's Profile
Full Name | Lake Avenue Eyecare Llc |
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Type | Facility |
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Speciality | Eyewear Supplier |
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Location | 829 Lake Ave, Gothenburg, Nebraska |
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Accepts Medicare Assignments | Does not participate in Medicare Program. The facility may not accept medicare assignment. |
NPI Data:
- NPI Number: 1396932430
- Provider Enumeration Date: 10/03/2007
- Last Update Date: 10/27/2022
Medical Identifiers
Medical identifiers for Lake Avenue Eyecare Llc such as npi, medicare ID, medicare PIN, medicaid, etc.
Identifier | Type | State | Issuer |
1396932430 | NPI | - | NPPES |
240481 | Other | | MIDLANDS CHOICE |
06754 | Other | | BLUE CROSS BLUE SHIELDPIN |
10024987700 | Medicaid | NE | |
Medical Taxonomies and Licenses
Taxonomy | Type | License (State) | Status |
152W00000X | Optometrist | 1166 (Nebraska) | Secondary |
332H00000X | Eyewear Supplier | 1166 (Nebraska) | Primary |
Medicare Part D Prescriber Enrollment
Any physician or other eligible professional who prescribes Part D drugs must either enroll in the Medicare program or opt out in order to prescribe drugs to their patients with Part D prescription drug benefit plans. Lake Avenue Eyecare Llc is
NOT enrolled with medicare and thus cannot prescribe medicare part D drugs to patients with medicare part D benefits.
Mailing Address and Practice Location
Mailing Address | Practice Location Address |
Lake Avenue Eyecare Llc 829 Lake Ave, Gothenburg, NE 69138-1943 Ph: (308) 537-3390 | Lake Avenue Eyecare Llc 829 Lake Ave, Gothenburg, NE 69138-1943 Ph: (308) 537-3390 |
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