Provider Demographics
NPI:1972323301
Name:VANCE THOMPSON VISION SURGERY CENTER CEDAR RAPIDS LLC
Entity type:Organization
Organization Name:VANCE THOMPSON VISION SURGERY CENTER CEDAR RAPIDS LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CFO
Authorized Official - Prefix:
Authorized Official - First Name:MARK
Authorized Official - Middle Name:ALLEN
Authorized Official - Last Name:SCHARNBERG
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:605-359-9155
Mailing Address - Street 1:3101 W 57TH ST
Mailing Address - Street 2:
Mailing Address - City:SIOUX FALLS
Mailing Address - State:SD
Mailing Address - Zip Code:57108-3162
Mailing Address - Country:US
Mailing Address - Phone:605-371-7100
Mailing Address - Fax:605-371-7199
Practice Address - Street 1:1136 H AVE NE
Practice Address - Street 2:
Practice Address - City:CEDAR RAPIDS
Practice Address - State:IA
Practice Address - Zip Code:52402-4624
Practice Address - Country:US
Practice Address - Phone:800-473-3968
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:VANCE THOMPSON VISION ASC HOLDINGS LLC
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2024-10-11
Last Update Date:2024-10-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QA1903XAmbulatory Health Care FacilitiesClinic/CenterAmbulatory Surgical