Organization
EYECARE ASSOCIATES OF COLUMBUS PC
Active
Other names
Subchapter S Corporation
Organization subpart
No
Provider details
NPI number
Authorized official
DR. LARRY MALICKY OD (OWNER)
(402) 564-0545
Entity
Organization
Contact information
Practice address
1371 29TH AVE, COLUMBUS, NE 68601-4926
(402) 564-0545
(402) 564-0078
Mailing address
PO BOX 1248, COLUMBUS, NE 68602-1248
(402) 564-0545
(402) 564-0078
Taxonomy
Speciality
Code
Description
License number
State
152W00000X
Optometrist
1069
NE
152W00000X
Optometrist
1091
NE
152W00000X
Optometrist
Primary
801
NE
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
06731
BCBS
NE
01
—
06952
BCBS
NE
01
—
36395
BCBS
NE
01
—
CH1483
RAILROAD MEDICARE
—
01
—
N001920
CHAMPUS
NE
Enumeration date
11/30/2006
Last updated
03/23/2012
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