Healthcare Provider Details
I. General information
NPI: 1427746403
Provider Name (Legal Business Name): SALUTE VISION CARE
Entity Type: Organization
Gender:
Sole Proprietor:
II. Dates (important events)
Enumeration Date: 04/27/2023
Last Update Date: 05/03/2023
Certification Date: 05/03/2023
Deactivation Date:
Reactivation Date:
III. Provider practice location address
106 MEYER AVE BLDG 166
OFFUTT AFB NE
68113-2000
US
IV. Provider business mailing address
3105 SHERIDAN RD
BELLEVUE NE
68123-5320
US
V. Phone/Fax
- Phone: 402-292-0396
- Fax: 402-292-2263
- Phone: 402-452-7854
- Fax:
VI. Provider taxonomy
Scope of Practice (Provider specialty)
| # 1 | |
| Primary Taxonomy | Y |
| Taxonomy Code | 152W00000X |
| Taxonomy | Optometrist |
| License Number | |
| License Number State | |
VIII. Authorized Official
Name: DR.
VIVIANLE
BENSON
FREEMAN
Title or Position: OPTOMETRIST
Credential: OD
Phone: 402-452-7854