| Gothenburg Eyecare & Optical | |
|
902 Avenue D, Ste 102 B, Gothenburg, NE 69138-1900 | |
| (308) 537-2020 | |
| (308) 537-2280 |
| Full Name | Gothenburg Eyecare & Optical |
|---|---|
| Type | Facility |
| Speciality | Optometrist |
| Location | 902 Avenue D, Gothenburg, Nebraska |
| Accepts Medicare Assignments | Medicare enrolled and accepts medicare insurance. Providers at this facility may prescribe medicare part D drugs. |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1245258292 | NPI | - | NPPES |
| 099868 | Other | NE | MEDICARE GROUP PROVIDER NUMBER |
| 10025277400 | Medicaid | NE |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 152W00000X | Optometrist | 1232 (Nebraska) | Primary |
| Provider Name | Kimberly A Johnson |
|---|---|
| Provider Type | Practitioner - Optometry |
| Provider Identifiers | NPI Number: 1407887755 PECOS PAC ID: 5991761520 Enrollment ID: I20041206000937 |
| Mailing Address | Practice Location Address |
|---|---|
| Gothenburg Eyecare & Optical 902 Avenue D, Ste 102 B, Gothenburg, NE 69138-1900 Ph: (308) 537-2020 | Gothenburg Eyecare & Optical 902 Avenue D, Ste 102 B, Gothenburg, NE 69138-1900 Ph: (308) 537-2020 |
Lake Avenue Eyecare Llc Optometrist Medicare: Not Enrolled in Medicare Practice Location: 829 Lake Ave, Gothenburg, NE 69138 Phone: 308-537-3390 Fax: 308-537-3391 | |
Kimberly A Johnson, O.D. Optometrist Medicare: Accepting Medicare Assignments Practice Location: 902 Avenue D Ste 102b, Gothenburg, NE 69138 Phone: 308-537-2020 Fax: 308-537-2280 | |
Lake Avenue Eyecare, Llc Optometrist Medicare: Not Enrolled in Medicare Practice Location: 829 Lake Ave, Gothenburg, NE 69138 Phone: 308-537-3390 Fax: 308-537-3391 |