Provider Demographics
NPI:1437100666
Name:HEARTLAND CATARACT & LASER SURGERY CENTER, INC.
Entity Type:Organization
Organization Name:HEARTLAND CATARACT & LASER SURGERY CENTER, INC.
Other - Org Name:HEARTLAND CATARACT & LASER SURGERY CENTER
Other - Org Type:Doing Business As
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:RICHARD
Authorized Official - Middle Name:J
Authorized Official - Last Name:MAW
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:402-292-6514
Mailing Address - Street 1:1103 GALVIN RD S, STE J
Mailing Address - Street 2:
Mailing Address - City:BELLEVUE
Mailing Address - State:NE
Mailing Address - Zip Code:68005-3002
Mailing Address - Country:US
Mailing Address - Phone:402-682-0688
Mailing Address - Fax:402-292-7122
Practice Address - Street 1:1103 GALVIN RD S, STE J
Practice Address - Street 2:
Practice Address - City:BELLEVUE
Practice Address - State:NE
Practice Address - Zip Code:68005-3002
Practice Address - Country:US
Practice Address - Phone:402-682-0688
Practice Address - Fax:402-292-7122
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-05-12
Last Update Date:2023-12-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QA1903XAmbulatory Health Care FacilitiesClinic/CenterAmbulatory Surgical
Provider Identifiers
StateIdentifier IDID TypeIssuer
NE098983Medicare Oscar/Certification