Healthcare Provider Details

I. General information

NPI: 1053582247
Provider Name (Legal Business Name): MID-PLAINS EYECARE CENTER PC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 03/17/2008
Last Update Date: 08/27/2009
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

135 9TH ST
SYRACUSE NE
68446-9740
US

IV. Provider business mailing address

PO BOX 10
SYRACUSE NE
68446-0010
US

V. Phone/Fax

Practice location:
  • Phone: 402-269-2321
  • Fax: 402-873-5149
Mailing address:
  • Phone: 402-269-2321
  • Fax: 402-269-3475

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code152W00000X
TaxonomyOptometrist
License Number833
License Number StateNE

VIII. Authorized Official

Name: DR. PAUL L SALANSKY JR.
Title or Position: PRESIDENT
Credential: O.D.
Phone: 402-269-2321