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Organization
OREGON TRAIL EYE SURGERY CENTER, INC
Active
Organization
OREGON TRAIL EYE SURGERY CENTER, INC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
BARBARA J. MIDDLE (ADMINISTRATOR)
(308) 635-3911
Entity
Organization
Contact information
Practice address
329 WEST 40TH STREET, SCOTTSBLUFF, NE 69361-4634
(308) 635-3911
(308) 635-3130
Mailing address
329 WEST 40TH STREET, SCOTTSBLUFF, NE 69361-4634
(308) 635-3911
(308) 635-3130
Taxonomy
Speciality
Code
Description
License number
State
261QA1903X
Ambulatory Surgical Clinic/Center
Primary
ASC039
NE
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
10025073600
—
NE
05
—
5490380
—
NE
Enumeration date
10/02/2006
Last updated
08/22/2020
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