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Organization
GERRY'S VISION SHOPPE, INC
Active
Organization
GERRY'S VISION SHOPPE, INC
Active
Other names
Gerry's Vision Shoppe
Organization subpart
No
Provider details
NPI number
Authorized official
HEIDI LYNN KLOCKMANN (PRESIDENT)
(320) 864-6111
Entity
Organization
Contact information
Practice address
1234 GREELEY AVE N, GLENCOE, MN 55336-2103
(320) 864-6111
(320) 864-6134
Mailing address
1234 GREELEY AVE N, PO BOX 186, GLENCOE, MN 55336-2103
(320) 864-6111
(320) 864-6134
Taxonomy
Speciality
Code
Description
License number
State
156FX1800X
Optician
—
—
332H00000X
Eyewear Supplier
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
16062GE
BCBS
—
01
—
21-18815
MEDICA
—
01
—
964661001450
PREFERRED ONE
—
Enumeration date
07/12/2005
Last updated
09/11/2025
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