Provider Demographics
NPI:1457467664
Name:MIDWEST EYE CARE PC
Entity Type:Organization
Organization Name:MIDWEST EYE CARE PC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:HR MANAGER
Authorized Official - Prefix:
Authorized Official - First Name:CALLA
Authorized Official - Middle Name:
Authorized Official - Last Name:PAPPAS
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:402-552-2020
Mailing Address - Street 1:2827 N CLARKSON ST
Mailing Address - Street 2:
Mailing Address - City:FREMONT
Mailing Address - State:NE
Mailing Address - Zip Code:68025-7714
Mailing Address - Country:US
Mailing Address - Phone:402-721-7222
Mailing Address - Fax:402-721-2473
Practice Address - Street 1:2827 N CLARKSON ST
Practice Address - Street 2:
Practice Address - City:FREMONT
Practice Address - State:NE
Practice Address - Zip Code:68025-7714
Practice Address - Country:US
Practice Address - Phone:402-721-7222
Practice Address - Fax:402-721-2473
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-08-21
Last Update Date:2022-06-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NE15441156FX1100X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes156FX1100XEye and Vision Services ProvidersTechnician/TechnologistOphthalmicGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
NEU34733Medicare UPIN
NEDO9052Medicare UPIN
NEE46515Medicare UPIN