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Organization

EYEWEAR SPECIALISTS INC

Active
Organization subpart
No

Provider details

NPI number
Authorized official
MS. CHERYL MAYNE (RCM MANAGER)
(952) 832-8100
Entity
Organization

Contact information

Practice address
209 CHALUPSKY AVE SE, NEW PRAGUE, MN 56071-2448
(952) 758-7892
(952) 758-7894
Mailing address
7450 FRANCE AVE S, SUITE 100, EDINA, MN 55435-4787
(952) 832-8120
(952) 832-8124

Taxonomy

Speciality
Code
Description
License number
State
332H00000X
Eyewear Supplier
Primary
4699580
MN

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
1251147-00
MN
01
170631
UCARE
MN
01
21-11723
MEDICA
MN
01
51083CL
BCBS
MN
Enumeration date
11/06/2006
Last updated
06/16/2016
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