Organization
NORTHEAST EYECARE PC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. BRANDON RIDDER OD (OWNER)
(402) 372-3266
Entity
Organization
Contact information
Practice address
101 W DECATUR ST, WEST POINT, NE 68788-1407
(402) 372-3266
(402) 372-5736
Mailing address
101 W DECATUR ST, WEST POINT, NE 68788-1407
(402) 372-3266
(402) 372-5736
Taxonomy
Speciality
Code
Description
License number
State
152W00000X
Optometrist
Primary
1396
NE
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
100264106-00
—
NE
05
—
100264775-00
—
NE
01
—
25136
COVENTRY
NE
01
—
7748
BLUE CROSS
NE
01
—
8422
MIDLANDS CHOICE
NE
Enumeration date
03/18/2014
Last updated
08/17/2015
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