EYEWEAR SPECIALISTS NPI 1215014378

NPI Information

  • NPI: 1215014378
  • Provider Name: EYEWEAR SPECIALISTS
  • Classification: Eyewear Supplier - 332H00000X
  • Entity Type: Organization
  • Address: 4201 DEAN LAKES BLVD
    SUITE 100
    SHAKOPEE, MN
    ZIP 55379
  • Phone: (952) 445-5763

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NPI Details

EYEWEAR SPECIALISTS is an eyewear supplier in Shakopee, MN. The provider is an organization that provides spectacles, contact lenses, and other vision enhancement devices prescribed by an optometrist or ophthalmologist. EYEWEAR SPECIALISTS NPI is 1215014378. The provider is registered as an organization entity type.

The provider's business location address is:

4201 DEAN LAKES BLVD
SUITE 100
SHAKOPEE, MN
ZIP 55379-829
Phone: (952) 445-5763
Fax: (952) 233-3029

The provider's authorized official is Cheryl Mayne .
The authorized official title is Rcm Manager and has the following contact phone number (952) 832-8100.

The enumeration date for this NPI number is 11/1/2006 and was last updated on 6/16/2016.

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
1332H00000XEyewear Supplier4699580MINNESOTAYes

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
121-27952OTHERMINNESOTAMEDICA
251083CLOTHERMINNESOTABCBS
36944973-00MEDICAIDMINNESOTA
40683720001MEDICARE ID-TYPE UNSPECIFIEDMINNESOTA

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: 11/21/2025

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