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Contact Information

EYE FASHIONS OPTICAL SHOPPE INC
202 NW 1ST AVE
GRAND RAPIDS, MN55744
 Phone: 218-326-0358
 Fax: 218-999-0067
 Website:
 

Specialty

Taxonomy Code Specialty Code Provider Type

Optometrist

152W00000X 41 Optometry
Indicates primary specialty

NPI Profile & details for EYE FASHIONS OPTICAL SHOPPE INC

NPI Number 1477624971
LBN Legal business name EYE FASHIONS OPTICAL SHOPPE INC
Authorized official LARRY SCHLAUDERAFF - (OWNER OPTOMETRIST)
Entity Organization
Organization subpart 1 No
Enumeration date 11/13/2006
Last updated 11/25/2024 - More than a year ago
Identifiers
MN License # 2415
MN Medicaid 593932000
Other 3C837EY BLUE PLUS
Other 3C838SC BLUE PLUS
Other 4C427EY BLUE PLUS
Other 3C837EY BLUE SHIELD
Other 3C838SC BLUE SHIELD
Other 974251008835 CBSA PPO
Other 1008835 COPORATE BENEFIT SERV
Other U33589 EYEMED
Other U33589 FIRSTPLAN
Other U33589 FIRSTPLANBLUE
Other HP29720 HEALTHPARTNERS
Other 2200897 MEDICA GR EX
Other 974251008835 PREFERRED ONE
MN Other 4C427EY MINN CARE BLUE PLUS
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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