Organization
PHYSICIANS EYEWEAR, L.L.C.
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. ROBERT S. PROFFITT M.D. (OWNER)
(308) 382-7223
Entity
Organization
Contact information
Practice address
711 N CUSTER AVE, STE 2, GRAND ISLAND, NE 68803-4311
(308) 382-7223
(308) 382-6299
Mailing address
711 N CUSTER AVE, STE 2, GRAND ISLAND, NE 68803-4311
(308) 382-7223
(308) 382-6299
Taxonomy
Speciality
Code
Description
License number
State
332B00000X
Durable Medical Equipment & Medical Supplies
—
—
332H00000X
Eyewear Supplier
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
100249654-00
—
NE
Enumeration date
05/24/2005
Last updated
04/21/2011
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