| |
112 S Chestnut St, Kimball, NE 69145-1257 | |
(308) 235-3649 | |
Not Available |
Full Name | |
---|---|
Type | Facility |
Speciality | Optometrist |
Location | 112 S Chestnut St, Kimball, Nebraska |
Accepts Medicare Assignments | Does not participate in Medicare Program. The facility may not accept medicare assignment. |
Identifier | Type | State | Issuer |
---|---|---|---|
1942333190 | NPI | - | NPPES |
1215933932 | Other | NE | INDIVIDUAL NPI # |
1710903984 | Other | NE | GROUP NPI FOR BVC |
506642584 | Medicaid | NE |
Taxonomy | Type | License (State) | Status |
---|---|---|---|
152W00000X | Optometrist | 876 (Nebraska) | Primary |
Mailing Address | Practice Location Address |
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416 Valley View Dr # 100, Scottsbluff, NE 69361-1486 Ph: (308) 635-1633 | 112 S Chestnut St, Kimball, NE 69145-1257 Ph: (308) 235-3649 |