Shopko Optical 105 is a
Eyewear Supplier based in Orem, Utah. Shopko Optical 105 is licensed to practice in * (Not Available) (license number ) and their current practice location is
125 S State St, Orem, Utah. It can be reached at their office (for appointments etc.) via phone at
(801) 225-4700.
NPI number for Shopko Optical 105 is 1396798161 and their current mailing address is 125 S State St, Orem, Utah. Shopko Optical 105
does not participate in medicare program and thus does not accept medicare assignments. The facility's NPI Number is 1396798161.
Healthcare Provider's Profile
Full Name | Shopko Optical 105 |
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Type | Facility |
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Speciality | Eyewear Supplier |
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Location | 125 S State St, Orem, Utah |
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Accepts Medicare Assignments | Does not participate in Medicare Program. The facility may not accept medicare assignment. |
NPI Data:
- NPI Number: 1396798161
- Provider Enumeration Date: 05/19/2006
- Last Update Date: 07/10/2008
Medical Identifiers
Medical identifiers for Shopko Optical 105 such as npi, medicare ID, medicare PIN, medicaid, etc.
Identifier | Type | State | Issuer |
1396798161 | NPI | - | NPPES |
014105 | Other | | VIP |
CP2230-46 | Other | | EYEMED |
35528 | Other | | AVESIS |
410985054-196 | Medicaid | UT | |
UT04884 | Other | UT | NORIDIAN SUBMITTER ID |
17928 | Other | | MEDICARE |
42586 | Other | | DAVIS |
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 105 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 105 125 S State St, Orem, UT 84058-5419 Ph: (801) 225-4700 | Shopko Optical 105 125 S State St, Orem, UT 84058-5419 Ph: (801) 225-4700 |
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