National Provider Identifier Database

LG OPTICAL ENTERPRISES
Eyewear Supplier

An organization that provides spectacles, contact lenses, and other vision enhancement devices prescribed by an optometrist or ophthalmologist.


Contact Information

LG OPTICAL ENTERPRISES
952 22ND AVE S
BROOKINGS, SD57006-2830
Phone: 605-692-8262
Fax: 605-692-9805
Website:
Specialty Taxonomy Code
* Eyewear Supplier 332H00000X

* Indicates primary specialty

NPI Profile & details for LG OPTICAL ENTERPRISES

NPI Number 1306016407
Legal business name
LBN
LG OPTICAL ENTERPRISES
Authorized official LYNN GANNON - (OWNER)
Entity Organization
Organization subpart No
Enumeration date 03/04/2008
Last updated 05/04/2015 - About 11 years ago
Sole proprietor1 Not specified
Identifiers
  • SD License #: 05001593786886EST001
  • SD Medicaid: 9281452
  • SD Other: 39879 AVESIS
  • SD Other: 4997613 BLUE CROSS BLUE SHIELD
  • SD Other: 9226299 DAKOTA CARE
  • SD Other: 111835 EYEMED

1 A sole proprietor/sole proprietorship is an individual, and as such, is eligible for a single NPI number. The sole proprietor must apply for the NPI number using his or her own Social Security Number (SSN), not an Employer Identification Number (EIN) even if he/she has an EIN.

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