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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