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Organization

PRAIRIE EYECARE CENTER PC

Active
Other names
Prairie Eyecare Center LLC
Organization subpart
No

Provider details

NPI number
Authorized official
DR. JEFFREY W SANGER O.D. (OWNER)
(308) 872-2291
Entity
Organization

Contact information

Practice address
408 S 8TH AVE, BROKEN BOW, NE 68822-2009
(308) 872-2291
(308) 872-3122
Mailing address
PO BOX 506, 408 S 8TH AVE, BROKEN BOW, NE 68822-0506
(308) 872-2291
(308) 872-3122

Taxonomy

Speciality
Code
Description
License number
State
152W00000X
Optometrist
Primary

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
10025628100
NE
05
47077269013
NE
01
C04190
PALMETTO GBA RAILROAD MED
NE
01
DN0887
RR MEDICARE PTAN
NE
Enumeration date
11/02/2005
Last updated
08/05/2008
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