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Contact Information

MOBILE EYECARE OF UTAH LLC
3665 S 8400 W
SUITE 100
MAGNA, UT84044-2214
 Phone: 801-250-5745
 Fax: 801-250-5981
 Website:
 

Specialty

Taxonomy Code Specialty Code Provider Type

Optometrist

152W00000X 41 Optometry
Indicates primary specialty

NPI Profile & details for MOBILE EYECARE OF UTAH LLC

NPI Number 1245274521
LBN Legal business name MOBILE EYECARE OF UTAH LLC
Authorized official SHAUN LARSEN - (OWNER)
Entity Organization
Organization subpart 1 No
Enumeration date 06/16/2006
Last updated 08/26/2010 - About 16 years ago
Identifiers
UT License # 3758049934
UT Medicaid 528455690016
1 Some organization health care providers are made up of components that furnish different types of health care or have separate physical locations where health care is furnished. These components and physical locations are not themselves legal entities, but are part of the organization health care provider (which is a legal entity). A covered organization provider may decide that its subparts (if it has any) should have their own NPI numbers. If a subpart conducts any HIPAA standard transactions on its own (e.g., separately from its parent), it must obtain its own NPI number.

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