Organization
EYE FASHIONS OPTICAL SHOPPE INC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. LARRY JAMES SCHLAUDERAFF OD (OWNER OPTOMETRIST)
(218) 326-0358
Entity
Organization
Contact information
Practice address
202 NW 1ST AVE, GRAND RAPIDS, MN 55744
(218) 326-0358
(218) 999-0067
Mailing address
202 NW 1ST AVE, GRAND RAPIDS, MN 55744
(218) 326-0358
(218) 326-0566
Taxonomy
Speciality
Code
Description
License number
State
152W00000X
Optometrist
Primary
2415
MN
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
1008835
COPORATE BENEFIT SERV
—
01
—
2200897
MEDICA GR EX
—
01
—
3C837EY
BLUE SHIELD
—
01
—
3C838SC
BLUE PLUS
—
01
—
4C427EY
MINN CARE BLUE PLUS
MN
01
—
4C427EY
BLUE PLUS
—
05
—
593932000
—
MN
01
—
974251008835
CBSA PPO
—
01
—
HP29720
HEALTHPARTNERS
—
01
—
U33589
FIRSTPLAN
—
Enumeration date
11/13/2006
Last updated
11/25/2024
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