Shopko Optical 108 is a
Eyewear Supplier based in Spanish Fork, Utah. Shopko Optical 108 is licensed to practice in * (Not Available) (license number ) and their current practice location is
955 N Main St, Spanish Fork, Utah. It can be reached at their office (for appointments etc.) via phone at
(801) 798-3557.
NPI number for Shopko Optical 108 is 1114970985 and their current mailing address is 955 N Main St, Spanish Fork, Utah. Shopko Optical 108
does not participate in medicare program and thus does not accept medicare assignments. The facility's NPI Number is 1114970985.
Healthcare Provider's Profile
| Full Name | Shopko Optical 108 |
|---|
| Type | Facility |
|---|
| Speciality | Eyewear Supplier |
|---|
| Location | 955 N Main St, Spanish Fork, Utah |
|---|
| Accepts Medicare Assignments | Does not participate in Medicare Program. The facility may not accept medicare assignment. |
|---|
NPI Data:
- NPI Number: 1114970985
- Provider Enumeration Date: 05/19/2006
- Last Update Date: 07/10/2008
Medical Identifiers
Medical identifiers for Shopko Optical 108 such as npi, medicare ID, medicare PIN, medicaid, etc.
| Identifier | Type | State | Issuer |
|---|
| 1114970985 | NPI | - | NPPES |
| 42506 | Other | | DAVIS |
| CP2230-52 | Other | | EYEMED |
| 410985054-300 | Medicaid | UT | |
| 17931 | Other | | MEDICARE |
| 014108 | Other | | VIP |
| 35536 | Other | | AVESIS |
| UT04874 | Other | UT | NORIDIAN SUBMITTER ID |
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 108 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 108
955 N Main St,
Spanish Fork, UT 84660-1150
Ph: (801) 798-3557 | Shopko Optical 108
955 N Main St,
Spanish Fork, UT 84660-1150
Ph: (801) 798-3557 |
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