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Organization

SIDNEY VISION CLINIC LLC

Active
Organization subpart
No

Provider details

NPI number
Authorized official
DR. JEFFREY ALAN COOK O.D. (PARTNER)
(308) 254-4041
Entity
Organization

Contact information

Practice address
900 PINE ST, SIDNEY, NE 69162-2241
(308) 254-4041
(308) 254-3718
Mailing address
PO BOX 61, SIDNEY, NE 69162-0061
(308) 254-4041
(308) 254-3718

Taxonomy

Speciality
Code
Description
License number
State
332B00000X
Durable Medical Equipment & Medical Supplies
Primary

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
10025341000
NE
01
245327
MIDLANDS CHOICE PROV NMBR
NE
01
37094
BLUE CROSS PROVIDER NMBR
NE
Enumeration date
04/11/2007
Last updated
02/18/2020
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