Provider Demographics
NPI:1861589780
Name:OMAHA EYECARE
Entity type:Organization
Organization Name:OMAHA EYECARE
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:COREY
Authorized Official - Middle Name:MICHAEL
Authorized Official - Last Name:LANGFORD
Authorized Official - Suffix:
Authorized Official - Credentials:OD
Authorized Official - Phone:402-333-2244
Mailing Address - Street 1:2730 S 114TH ST
Mailing Address - Street 2:
Mailing Address - City:OMAHA
Mailing Address - State:NE
Mailing Address - Zip Code:68144-4712
Mailing Address - Country:US
Mailing Address - Phone:402-333-2244
Mailing Address - Fax:402-333-5528
Practice Address - Street 1:2730 S 114TH ST
Practice Address - Street 2:
Practice Address - City:OMAHA
Practice Address - State:NE
Practice Address - Zip Code:68144-4712
Practice Address - Country:US
Practice Address - Phone:402-333-2244
Practice Address - Fax:402-333-5528
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-10-10
Last Update Date:2008-02-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes152W00000XEye and Vision Services ProvidersOptometristGroup - Multi-Specialty
No152WC0802XEye and Vision Services ProvidersOptometristCorneal and Contact ManagementGroup - Multi-Specialty
No152WL0500XEye and Vision Services ProvidersOptometristLow Vision RehabilitationGroup - Multi-Specialty
No152WP0200XEye and Vision Services ProvidersOptometristPediatricsGroup - Multi-Specialty
No152WS0006XEye and Vision Services ProvidersOptometristSports VisionGroup - Multi-Specialty
No152WX0102XEye and Vision Services ProvidersOptometristOccupational VisionGroup - Multi-Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
NEDB5959OtherMEDICARE RAILROAD CARRIER
NE5183070001OtherDMERC REGION D
NE10024996900Medicaid
NEDB5959OtherMEDICARE RAILROAD CARRIER