EYE-MART FACTORY OUTLET NPI 1215112776

NPI Information

NPI: 1215112776
Provider Name: EYE-MART FACTORY OUTLET
Classification: Eyewear Supplier - 332H00000X
Entity Type: Organization
Address:
2139 N 12TH ST
UNIT 5
GRAND JUNCTION, CO
ZIP 81501
Phone: (970) 241-2020
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EYE-MART FACTORY OUTLET is an eyewear supplier in Grand Junction, CO. The provider is an organization that provides spectacles, contact lenses, and other vision enhancement devices prescribed by an optometrist or ophthalmologist. EYE-MART FACTORY OUTLET NPI is 1215112776. The provider is registered as an organization entity type.

The provider's business location address is:

2139 N 12TH ST
UNIT 5
GRAND JUNCTION, CO
ZIP 81501-901
Phone: (970) 241-2020
Fax: (970) 241-7735

The provider's authorized official is Liz Anne Wicks .
The authorized official title is Manager and has the following contact phone number (970) 241-2884.

The enumeration date for this NPI number is 1/3/2008 and was last updated on 1/3/2008.

Taxonomy Codes

The NPI record includes the healthcare provider taxonomy classification, state license number and state of licensure. The following information regarding the scope of practice of this provider is available:

No.	Taxonomy Code	Taxonomy Clasification	Taxonomy Specialization	License Number	License State	Primary
1	332H00000X	Eyewear Supplier				Yes

Other Identifiers

The following information regarding additional identifiers associated to this NPI record includes the other identifier number, identifier type, identifier state and issuer.

No.	Other Provider Identifier	Other Provider Identifier Type	Other Provider Identifier State	Other Provider Identifier Issuer
1	COTP125233A	MEDICAID	COLORADO
2	1160760001	MEDICARE NSC	COLORADO

What is NPI?

NPI stands for National Provider Identifier. The NPI is a 10-digit identification number that is completely unique. The NPI number by itself does not contain any identifiable information such as a provider’s speciality or location. The NPI is assigned to individuals or organizacions for their lifespan and it is independent of key provider information type updates like a change of practices, location or speciality.

This page was last updated on: 5/5/2024

NPI Synchronization or Removal

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