| Grand Island Optical Pc | |
|
420 N Diers Ave, Grand Island, NE 68803-4979 | |
| (308) 384-0220 | |
| (308) 382-1650 |
| Full Name | Grand Island Optical Pc |
|---|---|
| Type | Facility |
| Speciality | Eyewear Supplier |
| Location | 420 N Diers Ave, Grand Island, Nebraska |
| Accepts Medicare Assignments | Medicare enrolled and accepts medicare insurance. Providers at this facility may prescribe medicare part D drugs. |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1891771051 | NPI | - | NPPES |
| 07783 | Other | BLUE CROSS BLUE SHIELD | |
| CS1323 | Other | RAILROAD MEDICARE | |
| 0290380001 | Other | MEDICARE DMERC |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 152W00000X | Optometrist | (* (Not Available)) | Secondary |
| 332H00000X | Eyewear Supplier | (* (Not Available)) | Primary |
| Provider Name | Jason James Langford |
|---|---|
| Provider Type | Practitioner - Optometry |
| Provider Identifiers | NPI Number: 1043296114 PECOS PAC ID: 8820129760 Enrollment ID: I20100622000100 |
| Provider Name | Dawn Michelle Langford |
|---|---|
| Provider Type | Practitioner - Optometry |
| Provider Identifiers | NPI Number: 1639156144 PECOS PAC ID: 6305977257 Enrollment ID: I20100622000255 |
| Provider Name | Christa Mary Hunnicutt |
|---|---|
| Provider Type | Practitioner - Optometry |
| Provider Identifiers | NPI Number: 1982832887 PECOS PAC ID: 5193857183 Enrollment ID: I20100709000029 |
| Provider Name | Tyler Andrew Hanson |
|---|---|
| Provider Type | Practitioner - Optometry |
| Provider Identifiers | NPI Number: 1104267103 PECOS PAC ID: 7315180890 Enrollment ID: I20130903000093 |
| Provider Name | William Anthony Kusek |
|---|---|
| Provider Type | Practitioner - Optometry |
| Provider Identifiers | NPI Number: 1912350687 PECOS PAC ID: 9931476884 Enrollment ID: I20170530002174 |
| Provider Name | Emily Laub |
|---|---|
| Provider Type | Practitioner - Optometry |
| Provider Identifiers | NPI Number: 1588427751 PECOS PAC ID: 8820533508 Enrollment ID: I20240717004318 |
| Mailing Address | Practice Location Address |
|---|---|
| Grand Island Optical Pc Po Box 5076, Grand Island, NE 68802-5076 Ph: (308) 384-0220 | Grand Island Optical Pc 420 N Diers Ave, Grand Island, NE 68803-4979 Ph: (308) 384-0220 |