Provider Demographics
NPI:1801107362
Name:FILIPS EYE CLINIC, P.C.
Entity type:Organization
Organization Name:FILIPS EYE CLINIC, P.C.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:ROGER
Authorized Official - Middle Name:J
Authorized Official - Last Name:FILIPS
Authorized Official - Suffix:
Authorized Official - Credentials:OD
Authorized Official - Phone:402-358-3700
Mailing Address - Street 1:PO BOX 87
Mailing Address - Street 2:
Mailing Address - City:CREIGHTON
Mailing Address - State:NE
Mailing Address - Zip Code:68729-0087
Mailing Address - Country:US
Mailing Address - Phone:402-358-3700
Mailing Address - Fax:402-358-3700
Practice Address - Street 1:817 MAIN ST.
Practice Address - Street 2:
Practice Address - City:CREIGHTON
Practice Address - State:NE
Practice Address - Zip Code:68729-0087
Practice Address - Country:US
Practice Address - Phone:402-358-3700
Practice Address - Fax:402-358-3700
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:FILIPS EYE CLINIC, P.C.
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2010-06-29
Last Update Date:2010-06-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NE914152W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes152W00000XEye and Vision Services ProvidersOptometristGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
NE=========12Medicaid
NE=========12Medicaid
NET40325Medicare UPIN
NE099792Medicare PIN