Provider Demographics
NPI:1053582247
Name:MID-PLAINS EYECARE CENTER PC
Entity type:Organization
Organization Name:MID-PLAINS EYECARE CENTER PC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:PAUL
Authorized Official - Middle Name:L
Authorized Official - Last Name:SALANSKY
Authorized Official - Suffix:JR
Authorized Official - Credentials:OD
Authorized Official - Phone:402-269-2321
Mailing Address - Street 1:PO BOX 10
Mailing Address - Street 2:
Mailing Address - City:SYRACUSE
Mailing Address - State:NE
Mailing Address - Zip Code:68446-0010
Mailing Address - Country:US
Mailing Address - Phone:402-269-2321
Mailing Address - Fax:402-269-3475
Practice Address - Street 1:135 9TH ST
Practice Address - Street 2:
Practice Address - City:SYRACUSE
Practice Address - State:NE
Practice Address - Zip Code:68446-9740
Practice Address - Country:US
Practice Address - Phone:402-269-2321
Practice Address - Fax:402-873-5149
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2008-03-17
Last Update Date:2009-08-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NE833152W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes152W00000XEye and Vision Services ProvidersOptometristGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
NE13691OtherMIDLANDS CHOICE
NE6737OtherBLUE CROSS BLUE SHIELD
NE2200004OtherUNITED HEALTH CARE
NE410022770OtherRR MEDICARE
NE=========01Medicaid
NE6737OtherBLUE CROSS BLUE SHIELD
NE=========01Medicaid
NE410022770OtherRR MEDICARE
NE097550Medicare PIN