NORTHERN UTAH EYE CENTER NPI 1225330673

NPI Information

  • NPI: 1225330673
  • Provider Name: NORTHERN UTAH EYE CENTER
  • Classification: Eyewear Supplier - 332H00000X
  • Entity Type: Organization
  • Other Name: THE OPTICAL SHOPPE
  • CLIA Number: 46D2259298
  • Address: 550 E 1400 N STE T
    LOGAN, UT
    ZIP 84341
  • Phone: (435) 752-2020

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NPI Details

NORTHERN UTAH EYE CENTER is an eyewear supplier in Logan, UT. The provider is an organization that provides spectacles, contact lenses, and other vision enhancement devices prescribed by an optometrist or ophthalmologist. NORTHERN UTAH EYE CENTER NPI is 1225330673. The provider is registered as an organization entity type and is a single specialty group.
The provider Other Name Is The Optical Shoppe.

The provider's business location address is:

550 E 1400 N STE T
LOGAN, UT
ZIP 84341-407
Phone: (435) 752-2020
Fax: (435) 752-5475

The provider's authorized official is Christian D Nilson .
The authorized official title is Owner and has the following contact phone number (435) 752-2020.

The CLIA number assigned to this NPI record is 46D2259298 - physician office with a certificate type of Certificate of Waiver.

The enumeration date for this NPI number is 11/17/2010 and was last updated on 8/29/2017.

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
1152W00000XOptometrist8127835-9934UTAHNo
2332H00000XEyewear Supplier6962612-1205UTAHYes

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
119583MEDICARE PINUTAH
21932321460MEDICAIDUTAH

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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