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
10114 MAPLE ST, OMAHA, NE 68134-5555
(402) 571-8112
(402) 571-8113
Mailing address
409 N 78TH ST, OMAHA, NE 68114-3638
(402) 393-4500
(402) 393-4500
Taxonomy
Speciality
Code
Description
License number
State
152W00000X
Optometrist
Primary
—
—
332H00000X
Eyewear Supplier
470486594
NE
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
47048659405
—
NE
Enumeration date
11/15/2007
Last updated
01/22/2021
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