UNDERWOOD OPTICAL INC NPI 1700080769

NPI Information

NPI: 1700080769
Provider Name: UNDERWOOD OPTICAL INC
Classification: Eyewear Supplier - 332H00000X
Entity Type: Organization
Address:
22 S BEECH ST
CORTEZ, CO
ZIP 81321
Phone: (970) 565-7195
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UNDERWOOD OPTICAL INC is an eyewear supplier in Cortez, CO. The provider is an organization that provides spectacles, contact lenses, and other vision enhancement devices prescribed by an optometrist or ophthalmologist. UNDERWOOD OPTICAL INC NPI is 1700080769. The provider is registered as an organization entity type and is a single specialty group.

The provider's business location address is:

22 S BEECH ST
CORTEZ, CO
ZIP 81321-744
Phone: (970) 565-7195
Fax: (970) 565-7171

The provider's authorized official is Robert D Underwood .
The authorized official title is Optometrist and has the following contact phone number (970) 565-7195.

The enumeration date for this NPI number is 6/13/2007 and was last updated on 11/3/2011.

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	152W00000X	Optometrist		1245	COLORADO	No
2	332H00000X	Eyewear Supplier		1245	COLORADO	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	410029516	MEDICARE PIN	COLORADO
2	0446530001	MEDICARE NSC	COLORADO
3	3444	OTHER	COLORADO	BCBS
4	T60863	MEDICARE UPIN	COLORADO
5	COA103386	MEDICARE PIN	COLORADO
6	08124596	MEDICAID	COLORADO

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

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