SPECTACLE SHOP L L C NPI 1992792600

NPI Information

NPI: 1992792600
Provider Name: SPECTACLE SHOP L L C

Other Name: THE SPECTACLE SHOP LLC

Classification: Eyewear Supplier - 332H00000X
Entity Type: Organization
Address:
415 W 3RD ST
YANKTON, SD
ZIP 57078
Phone: (605) 665-9638
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SPECTACLE SHOP L L C is an eyewear supplier in Yankton, SD. The provider is an organization that provides spectacles, contact lenses, and other vision enhancement devices prescribed by an optometrist or ophthalmologist. SPECTACLE SHOP L L C NPI is 1992792600. The provider is registered as an organization entity type.
The provider Other Name Is The Spectacle Shop Llc.

The provider's business location address is:

415 W 3RD ST
YANKTON, SD
ZIP 57078-201
Phone: (605) 665-9638
Fax: (605) 665-0526

The provider's authorized official is Jon Michael Kinsley .
The authorized official title is Manager and has the following contact phone number (605) 665-9638.

The enumeration date for this NPI number is 9/29/2005 and was last updated on 2/5/2015.

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	100249545-00	MEDICAID	NEBRASKA
2	9281510	MEDICAID	SOUTH DAKOTA

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: 11/14/2023

NPI Synchronization or Removal

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