FIFTH AVENUE OF EDINA INC. NPI 1821243239

NPI Information

FIFTH AVENUE OF EDINA INC. is an eyewear supplier in Edina, MN. The provider is an organization that provides spectacles, contact lenses, and other vision enhancement devices prescribed by an optometrist or ophthalmologist. FIFTH AVENUE OF EDINA INC. NPI is 1821243239. The provider is registered as an organization entity type and is a single specialty group.
The provider Other Name Is Fifth Avenue Optical.

The provider's business location address is:

3540 GALLERIA
EDINA, MN
ZIP 55435-218
Phone: (952) 922-1052
Fax: (952) 922-2518

The provider's authorized official is Gale L Stead .
The authorized official title is Owner and has the following contact phone number (952) 922-1052.

The enumeration date for this NPI number is 11/26/2008 and was last updated on 6/13/2012.

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:

Other Identifiers

The following information regarding additional identifiers associated to this NPI record includes the other identifier number, identifier type, identifier state and issuer.

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