Shopko Optical 091 in Logan, UT - Eyewear Supplier

Shopko Optical 091 is a Eyewear Supplier based in Logan, Utah. Shopko Optical 091 is licensed to practice in * (Not Available) (license number ) and their current practice location is 1341 N Main St, Logan, Utah. It can be reached at their office (for appointments etc.) via phone at (435) 753-0700.

NPI number for Shopko Optical 091 is 1609828136 and their current mailing address is 1341 N Main St, Logan, Utah. Shopko Optical 091 does not participate in medicare program and thus does not accept medicare assignments. The facility's NPI Number is 1609828136.

Contact Information

	Shopko Optical 091
	1341 N Main St, Logan, UT 84341-2221
	(435) 753-0700
	Not Available

Healthcare Provider's Profile

Full Name	Shopko Optical 091
Type	Facility
Speciality	Eyewear Supplier
Location	1341 N Main St, Logan, Utah
Accepts Medicare Assignments	Does not participate in Medicare Program. The facility may not accept medicare assignment.

NPI Data:

NPI Number: 1609828136
Provider Enumeration Date: 05/16/2006
Last Update Date: 07/10/2008

Medical Identifiers

Medical identifiers for Shopko Optical 091 such as npi, medicare ID, medicare PIN, medicaid, etc.

Identifier	Type	State	Issuer
1609828136	NPI	-	NPPES
35721	Other		AVESIS
014091	Other		VIP
410985054-148	Medicaid	UT
CP2230-43	Other		EYEMED
17924	Other		MEDICARE
UT04878	Other	UT	NORIDIAN SUBMITTER ID
42567	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 091 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 091 1341 N Main St, Logan, UT 84341-2221 Ph: (435) 753-0700	Shopko Optical 091 1341 N Main St, Logan, UT 84341-2221 Ph: (435) 753-0700

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Shopko Optical 091 - in Logan, UT