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GIBBONS OPTICAL LLC NPI 1851585822


NPI Information

NPI: 1851585822
Provider Name: GIBBONS OPTICAL, LLC
Classification: Eyewear Supplier - 332H00000X
Entity Type: Organization
Address:
150 17TH AVE NW
ROCHESTER, MN
ZIP 55901
Phone: (507) 288-6964
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GIBBONS OPTICAL, LLC is an eyewear supplier in Rochester, MN. The provider is an organization that provides spectacles, contact lenses, and other vision enhancement devices prescribed by an optometrist or ophthalmologist. GIBBONS OPTICAL, LLC NPI is 1851585822. The provider is registered as an organization entity type.

The provider's business location address is:

150 17TH AVE NW
ROCHESTER, MN
ZIP 55901-321
Phone: (507) 288-6964
Fax: (507) 252-5307

The provider's authorized official is Karen Marie Bjorngaard .
The authorized official title is Optometrist and has the following contact phone number (507) 288-6964.

The enumeration date for this NPI number is 8/31/2007 and was last updated on 5/27/2008.


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 CodeTaxonomy ClasificationTaxonomy SpecializationLicense NumberLicense StatePrimary
1332H00000XEyewear Supplier2343MINNESOTAYes

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 IdentifierOther Provider Identifier TypeOther Provider Identifier StateOther Provider Identifier Issuer
15036650001MEDICARE NSC
2691325300MEDICAIDMINNESOTA
3U30915MEDICARE UPIN

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: 4/28/2024

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