Shopko Optical 086 is a
Eyewear Supplier based in Provo, Utah. Shopko Optical 086 is licensed to practice in * (Not Available) (license number ) and their current practice location is
2266 N University Pkwy, Provo, Utah. It can be reached at their office (for appointments etc.) via phone at
(801) 373-1300.
NPI number for Shopko Optical 086 is 1982656419 and their current mailing address is 2266 N University Pkwy, Provo, Utah. Shopko Optical 086
does not participate in medicare program and thus does not accept medicare assignments. The facility's NPI Number is 1982656419.
Healthcare Provider's Profile
| Full Name | Shopko Optical 086 |
|---|
| Type | Facility |
|---|
| Speciality | Eyewear Supplier |
|---|
| Location | 2266 N University Pkwy, Provo, Utah |
|---|
| Accepts Medicare Assignments | Does not participate in Medicare Program. The facility may not accept medicare assignment. |
|---|
NPI Data:
- NPI Number: 1982656419
- Provider Enumeration Date: 05/16/2006
- Last Update Date: 07/10/2008
Medical Identifiers
Medical identifiers for Shopko Optical 086 such as npi, medicare ID, medicare PIN, medicaid, etc.
| Identifier | Type | State | Issuer |
|---|
| 1982656419 | NPI | - | NPPES |
| 014086 | Other | | VIP |
| 17921 | Other | | MEDICARE |
| 410985054-134 | Medicaid | UT | |
| UT04881 | Other | UT | NORIDIAN SUBMITTER ID |
| 35529 | Other | | AVESIS |
| 42548 | Other | | DAVIS |
| CP2230-47 | Other | | EYEMED |
Medical Taxonomies and Licenses
| Taxonomy | Type | License (State) | Status |
|---|
| 152W00000X | Optometrist | (* (Not Available)) | Secondary |
| 156FX1800X | Technician/technologist - Optician | (* (Not Available)) | Secondary |
| 332H00000X | Eyewear Supplier | (* (Not Available)) | Primary |
Medicare Part D Prescriber Enrollment
Any physician or other eligible professional who prescribes Part D drugs must either enroll in the Medicare program or opt out in order to prescribe drugs to their patients with Part D prescription drug benefit plans. Shopko Optical 086 is
NOT enrolled with medicare and thus cannot prescribe medicare part D drugs to patients with medicare part D benefits.
Mailing Address and Practice Location
| Mailing Address | Practice Location Address |
|---|
Shopko Optical 086
2266 N University Pkwy,
Provo, UT 84604-1510
Ph: (801) 373-1300 | Shopko Optical 086
2266 N University Pkwy,
Provo, UT 84604-1510
Ph: (801) 373-1300 |
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