Shopko Optical 105 is a
Eyewear Supplier based in Orem, Utah. Shopko Optical 105 is licensed to practice in * (Not Available) (license number ) and their current practice location is
125 S State St, Orem, Utah. It can be reached at their office (for appointments etc.) via phone at
(801) 225-4700.
NPI number for Shopko Optical 105 is 1396798161 and their current mailing address is 125 S State St, Orem, Utah. Shopko Optical 105
does not participate in medicare program and thus does not accept medicare assignments. The facility's NPI Number is 1396798161.
Healthcare Provider's Profile
| Full Name | Shopko Optical 105 |
|---|
| Type | Facility |
|---|
| Speciality | Eyewear Supplier |
|---|
| Location | 125 S State St, Orem, Utah |
|---|
| Accepts Medicare Assignments | Does not participate in Medicare Program. The facility may not accept medicare assignment. |
|---|
NPI Data:
- NPI Number: 1396798161
- Provider Enumeration Date: 05/19/2006
- Last Update Date: 07/10/2008
Medical Identifiers
Medical identifiers for Shopko Optical 105 such as npi, medicare ID, medicare PIN, medicaid, etc.
| Identifier | Type | State | Issuer |
|---|
| 1396798161 | NPI | - | NPPES |
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 105 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 105
125 S State St,
Orem, UT 84058-5419
Ph: (801) 225-4700 | Shopko Optical 105
125 S State St,
Orem, UT 84058-5419
Ph: (801) 225-4700 |
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