Provider Demographics
NPI:1427746403
Name:SALUTE VISION CARE
Entity type:Organization
Organization Name:SALUTE VISION CARE
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OPTOMETRIST
Authorized Official - Prefix:DR
Authorized Official - First Name:VIVIANLE
Authorized Official - Middle Name:BENSON
Authorized Official - Last Name:FREEMAN
Authorized Official - Suffix:
Authorized Official - Credentials:OD
Authorized Official - Phone:402-452-7854
Mailing Address - Street 1:3105 SHERIDAN RD
Mailing Address - Street 2:
Mailing Address - City:BELLEVUE
Mailing Address - State:NE
Mailing Address - Zip Code:68123-5320
Mailing Address - Country:US
Mailing Address - Phone:402-452-7854
Mailing Address - Fax:
Practice Address - Street 1:106 MEYER AVE BLDG 166
Practice Address - Street 2:
Practice Address - City:OFFUTT AFB
Practice Address - State:NE
Practice Address - Zip Code:68113-2000
Practice Address - Country:US
Practice Address - Phone:402-292-0396
Practice Address - Fax:402-292-2263
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2023-04-27
Last Update Date:2023-05-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes152W00000XEye and Vision Services ProvidersOptometristGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
NE1366439010OtherVIVIANLE FREEMAN
1427746403OtherNPI2