Shopko Optical 107 is a
Eyewear Supplier based in Bountiful, Utah. Shopko Optical 107 is licensed to practice in * (Not Available) (license number ) and their current practice location is
190 S 500 W, Bountiful, Utah. It can be reached at their office (for appointments etc.) via phone at
(801) 295-9200.
NPI number for Shopko Optical 107 is 1205889078 and their current mailing address is 190 S 500 W, Bountiful, Utah. Shopko Optical 107
does not participate in medicare program and thus does not accept medicare assignments. The facility's NPI Number is 1205889078.
Healthcare Provider's Profile
Full Name | Shopko Optical 107 |
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Type | Facility |
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Speciality | Eyewear Supplier |
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Location | 190 S 500 W, Bountiful, 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: 1205889078
- Provider Enumeration Date: 05/19/2006
- Last Update Date: 07/10/2008
Medical Identifiers
Medical identifiers for Shopko Optical 107 such as npi, medicare ID, medicare PIN, medicaid, etc.
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 | |
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 107 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 107 190 S 500 W, Bountiful, UT 84010-8729 Ph: (801) 295-9200 | Shopko Optical 107 190 S 500 W, Bountiful, UT 84010-8729 Ph: (801) 295-9200 |
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