| |
190 S 500 W, Bountiful, UT 84010-8729 | |
(801) 295-9200 | |
Not Available |
Full Name | |
---|---|
Type | Facility |
Speciality | Eyewear Supplier |
Location | 190 S 500 W, Bountiful, Utah |
Accepts Medicare Assignments | Does not participate in Medicare Program. The facility may not accept medicare assignment. |
Identifier | Type | State | Issuer |
---|---|---|---|
1205889078 | NPI | - | NPPES |
17929 | Other | MEDICARE | |
014107 | Other | VIP | |
UT04877 | Other | UT | NORIDIAN SUBMITTER ID |
CP2230-53 | Other | EYEMED | |
42591 | Other | DAVIS | |
35537 | Other | AVESIS | |
410985054-229 | Medicaid | UT |
Mailing Address | Practice Location Address |
---|---|
190 S 500 W, Bountiful, UT 84010-8729 Ph: (801) 295-9200 | 190 S 500 W, Bountiful, UT 84010-8729 Ph: (801) 295-9200 |