SHEBOYGAN OPTICAL CO. LLC NPI 1356465785

NPI Information

NPI: 1356465785
Provider Name: SHEBOYGAN OPTICAL CO. LLC
Classification: Eyewear Supplier - 332H00000X
Entity Type: Organization
Address:
1442 N 31ST ST
SHEBOYGAN, WI
ZIP 53081
Phone: (920) 458-5096
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SHEBOYGAN OPTICAL CO. LLC is an eyewear supplier in Sheboygan, WI. The provider is an organization that provides spectacles, contact lenses, and other vision enhancement devices prescribed by an optometrist or ophthalmologist. SHEBOYGAN OPTICAL CO. LLC NPI is 1356465785. The provider is registered as an organization entity type.

The provider's business location address is:

1442 N 31ST ST
SHEBOYGAN, WI
ZIP 53081-061
Phone: (920) 458-5096
Fax: (920) 451-1085

The provider's authorized official is Christopher Larson .
The authorized official title is Owner and has the following contact phone number (920) 458-5096.

The enumeration date for this NPI number is 3/19/2007 and was last updated on 7/8/2014.

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	0587980001	MEDICARE ID-TYPE UNSPECIFIED	WISCONSIN
2	0587980001	MEDICARE NSC	WISCONSIN

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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