| |
4060 Riverdale Rd, Riverdale, UT 84405-1518 | |
(801) 392-4300 | |
Not Available |
Full Name | |
---|---|
Type | Facility |
Speciality | Eyewear Supplier |
Location | 4060 Riverdale Rd, Riverdale, Utah |
Accepts Medicare Assignments | Does not participate in Medicare Program. The facility may not accept medicare assignment. |
Identifier | Type | State | Issuer |
---|---|---|---|
1295788065 | NPI | - | NPPES |
410985054-408 | Medicaid | UT | |
014109 | Other | VIP | |
UT04871 | Other | UT | NORIDIAN SUBMITTER ID |
42510 | Other | DAVIS | |
17932 | Other | MEDICARE | |
000090125 | Other | MEDICARE | |
CP2230-48 | Other | EYEMED |
Mailing Address | Practice Location Address |
---|---|
4060 Riverdale Rd, Riverdale, UT 84405-1518 Ph: (801) 392-4300 | 4060 Riverdale Rd, Riverdale, UT 84405-1518 Ph: (801) 392-4300 |