Provider Demographics
NPI:1467665042
Name:NEBRASKA EYE INSTITUTE
Entity Type:Organization
Organization Name:NEBRASKA EYE INSTITUTE
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:DOUGLAS
Authorized Official - Middle Name:C
Authorized Official - Last Name:RIENKS
Authorized Official - Suffix:
Authorized Official - Credentials:OD
Authorized Official - Phone:402-435-1166
Mailing Address - Street 1:2550 SUPERIOR ST
Mailing Address - Street 2:SUITE 150
Mailing Address - City:LINCOLN
Mailing Address - State:NE
Mailing Address - Zip Code:68521-4155
Mailing Address - Country:US
Mailing Address - Phone:402-435-1166
Mailing Address - Fax:402-435-1194
Practice Address - Street 1:4640 CHAMPLAIN DR
Practice Address - Street 2:SUITE 113
Practice Address - City:LINCOLN
Practice Address - State:NE
Practice Address - Zip Code:68521-4714
Practice Address - Country:US
Practice Address - Phone:402-435-1166
Practice Address - Fax:402-435-1194
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-05-08
Last Update Date:2009-08-31
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NE1014152W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes152W00000XEye and Vision Services ProvidersOptometristGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
NE36355OtherBLUE CROSS BLUE SHIELD
NE=========OtherUNITED HEALTH CARE
NE36355OtherBLUE CROSS BLUE SHIELD
NE=========00Medicaid
NE=========OtherMIDLANDS CHOICE
NEU19213Medicare UPIN
NE4112760001Medicare NSC
NE274141Medicare PIN