Organization
INTERNATIONAL EYECARE CENTER, INC.
Active
Other names
Malbar Vision
Organization subpart
No
Provider details
NPI number
Authorized official
CATHY LEE SHORT (CREDENTIALING MANAGER)
(618) 462-9818
Entity
Organization
Contact information
Practice address
409 N 78TH ST, OMAHA, NE 68114-3638
(402) 391-6600
(402) 393-6890
Mailing address
409 N 78TH ST, OMAHA, NE 68114-3638
(402) 393-4500
(402) 393-7457
Taxonomy
Speciality
Code
Description
License number
State
152W00000X
Optometrist
Primary
—
—
332H00000X
Eyewear Supplier
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
47048659404
—
NE
Enumeration date
07/18/2005
Last updated
01/22/2021
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