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DESERT MEDICAL EYE CENTER OPTICAL SHOP NPI 1568422335


NPI Information

NPI: 1568422335
Provider Name: DESERT MEDICAL EYE CENTER OPTICAL SHOP
Classification: Eyewear Supplier - 332H00000X
Entity Type: Organization
Address:
4324 S EASTERN AVE
SUITE A
LAS VEGAS, NV
ZIP 89119
Phone: (702) 734-9585
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DESERT MEDICAL EYE CENTER OPTICAL SHOP is an eyewear supplier in Las Vegas, NV. The provider is an organization that provides spectacles, contact lenses, and other vision enhancement devices prescribed by an optometrist or ophthalmologist. DESERT MEDICAL EYE CENTER OPTICAL SHOP NPI is 1568422335. The provider is registered as an organization entity type.

The provider's business location address is:

4324 S EASTERN AVE
SUITE A
LAS VEGAS, NV
ZIP 89119-016
Phone: (702) 734-9585
Fax: (702) 734-9518

The provider's authorized official is Judy M Craythorn .
The authorized official title is Owner/director and has the following contact phone number (702) 734-9585.

The enumeration date for this NPI number is 3/24/2006 and was last updated on 8/11/2008.


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 CodeTaxonomy ClasificationTaxonomy SpecializationLicense NumberLicense StatePrimary
1332H00000XEyewear Supplier5468NEVADAYes

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 IdentifierOther Provider Identifier TypeOther Provider Identifier StateOther Provider Identifier Issuer
1060332001MEDICARE ID-TYPE UNSPECIFIED
218005746MEDICARE ID-TYPE UNSPECIFIEDRAIL ROAD MEDICARE

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: 4/28/2024

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