Organization
DISTINCTIVE EYEWEAR, LLC
Active
Other names
Northwest Eyewear
Organization subpart
No
Provider details
NPI number
Authorized official
KELLY PETTENGILL (CREDENTIALING AND DATA MANAGEMENT)
(763) 416-7629
Entity
Organization
Contact information
Practice address
12000 ELM CREEK BLVD N STE 100, MAPLE GROVE, MN 55369-7074
(763) 416-7653
(763) 416-7634
Mailing address
8401 GOLDEN VALLEY RD STE 330, GOLDEN VALLEY, MN 55427-4488
(763) 416-7629
(763) 383-4147
Taxonomy
Speciality
Code
Description
License number
State
156FX1800X
Optician
—
—
332H00000X
Eyewear Supplier
Primary
—
—
Other
Enumeration date
10/20/2006
Last updated
03/18/2020
About Stedi
Stedi is the only programmable healthcare clearinghouse. You can use Stedi's APIs to process eligibility checks, claims, remits, and more.
Contact us