Provider Demographics
NPI:1457509382
Name:LIND OPTICAL INC
Entity Type:Organization
Organization Name:LIND OPTICAL INC
Other - Org Name:LIND OPTICAL
Other - Org Type:Other Name
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:DIANA
Authorized Official - Middle Name:M
Authorized Official - Last Name:LIND
Authorized Official - Suffix:
Authorized Official - Credentials:DO
Authorized Official - Phone:308-236-8500
Mailing Address - Street 1:3808 28TH AVE STE A
Mailing Address - Street 2:
Mailing Address - City:KEARNEY
Mailing Address - State:NE
Mailing Address - Zip Code:68845-1290
Mailing Address - Country:US
Mailing Address - Phone:308-865-2757
Mailing Address - Fax:
Practice Address - Street 1:4107 7TH AVE
Practice Address - Street 2:
Practice Address - City:KEARNEY
Practice Address - State:NE
Practice Address - Zip Code:68845-1312
Practice Address - Country:US
Practice Address - Phone:308-865-2757
Practice Address - Fax:308-865-2758
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2008-09-04
Last Update Date:2009-02-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NE26981ABOC156FX1800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes156FX1800XEye and Vision Services ProvidersTechnician/TechnologistOpticianGroup - Multi-Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
NE6157090001Medicare NSC