Provider Demographics
NPI:1992761191
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 691
Mailing Address - Street 2:
Mailing Address - City:NEBRASKA CITY
Mailing Address - State:NE
Mailing Address - Zip Code:68410-0691
Mailing Address - Country:US
Mailing Address - Phone:402-873-6696
Mailing Address - Fax:402-873-5149
Practice Address - Street 1:121 N 8TH ST
Practice Address - Street 2:
Practice Address - City:NEBRASKA CITY
Practice Address - State:NE
Practice Address - Zip Code:68410-2441
Practice Address - Country:US
Practice Address - Phone:402-873-6696
Practice Address - Fax:402-873-5149
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-04-25
Last Update Date:2012-01-31
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes152W00000XEye and Vision Services ProvidersOptometristGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
NE2200002OtherUHITED HEALTH CARE
NE6737OtherBLUE CROSS BLUE SHIELD
NE094239OtherMEDICARE CLINIC
NE410022770OtherRR MEDICARE
NE410029442OtherRR MEDICARE
NE13691OtherMIDLANDS CHOICE
NE2200004OtherUNITED HEALTHCARE
NE2200004OtherUNITED HEALTHCARE
NE094239OtherMEDICARE CLINIC
NE410022770OtherRR MEDICARE
NE13691OtherMIDLANDS CHOICE
NE6737OtherBLUE CROSS BLUE SHIELD
097550Medicare PIN
NE2200004OtherUNITED HEALTHCARE
094247Medicare ID - Type Unspecified
NE0448340002Medicare NSC