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Contact Information

ILLUSIONS EYEWEAR LLC
8616 N 30TH ST
OMAHA, NE68112-1808
 Phone: 402-451-1717
 Fax: 402-451-3469
 Website:
 

Specialty

Taxonomy Code Specialty Code Provider Type

Eyewear Supplier

332H00000X 87 All Other Suppliers
 

Optometrist

152W00000X 41 Optometry
Indicates primary specialty

NPI Profile & details for ILLUSIONS EYEWEAR LLC

NPI # 1134252711
LBN Legal business name ILLUSIONS EYEWEAR LLC
Authorized official TOMMIE BLAN - (OPTICIAN OWNER)
Entity Organization
Organization subpart 1 No
Enumeration date 03/13/2007
Last updated 06/11/2008 - About 18 years ago
Identifiers
NE Medicaid 017542
NE Medicaid 10025369100
Other NA1057 PTAN
1 Some organization health care providers are made up of components that furnish different types of health care or have separate physical locations where health care is furnished. These components and physical locations are not themselves legal entities, but are part of the organization health care provider (which is a legal entity). A covered organization provider may decide that its subparts (if it has any) should have their own NPI numbers. If a subpart conducts any HIPAA standard transactions on its own (e.g., separately from its parent), it must obtain its own NPI number.

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