| |
2290 S 1300 E, Salt Lake City, UT 84106-2831 | |
(801) 467-8989 | |
Not Available |
Full Name | |
---|---|
Type | Facility |
Speciality | Eyewear Supplier |
Location | 2290 S 1300 E, Salt Lake City, Utah |
Accepts Medicare Assignments | Does not participate in Medicare Program. The facility may not accept medicare assignment. |
Identifier | Type | State | Issuer |
---|---|---|---|
1568415339 | NPI | - | NPPES |
CP2230-50 | Other | EYEMED | |
35534 | Other | AVESIS | |
410985054-246 | Medicaid | UT | |
17933 | Other | MEDICARE | |
410985054-4110 | Other | NATIONAL VISION ADMIN | |
014110 | Other | VIP | |
42512 | Other | DAVIS | |
UT03960 | Other | UT | NORIDIAN SUBMITTER ID |
Mailing Address | Practice Location Address |
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2290 S 1300 E, Salt Lake City, UT 84106-2831 Ph: (801) 467-8989 | 2290 S 1300 E, Salt Lake City, UT 84106-2831 Ph: (801) 467-8989 |