Organization
OPTICAL GALLERY, LLC
Active
Other names
OPTICAL GALLERY
Organization subpart
No
Provider details
NPI number
Authorized official
MICHAEL J THILGES (PARTOWNER/MANAGER)
(402) 488-3106
Entity
Organization
Contact information
Practice address
3923 S 48TH ST, LINCOLN, NE 68506-4318
(402) 488-3106
(402) 488-3329
Mailing address
3923 S 48TH ST, LINCOLN, NE 68506-4318
(402) 488-3106
(402) 488-3329
Taxonomy
Speciality
Code
Description
License number
State
332H00000X
Eyewear Supplier
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
10025614200
—
NE
01
—
DN6715
MEDICARE RAILROAD CARRIER
NE
Enumeration date
04/02/2008
Last updated
05/04/2009
Update your record
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