Southdale Optical Co in Edina - Eyewear Supplier
Southdale Optical Co - NPI 1871576306
Southdale Optical Co is a Eyewear Supplier in Edina, Minnesota. Southdale Optical Co practices all healthcare services and medical treatments related to Eyewear Supplier. The NPI Number for Southdale Optical Co is 1871576306. The last update date is 2009-06-16.
Southdale Optical Co's current location address is 6533 Drew Ave S, Edina, Minnesota. You can contact this provider via phone number 9529259550 and fax number 9529259748. The mailing address for Southdale Optical Co is 6533 Drew Ave S, Edina, Minnesota. To know further, please read the information below!
Provider Profile Detail
| Provider Organization | Southdale Optical Co |
|---|---|
| Address | 6533 Drew Ave S, Edina, Minnesota |
| Phone Number | 9529259550 |
| Fax Number | 9529259748 |
| Sole Proprietor | -- |
| Credentials | -- |
Authorized Official
| Title or Position | PRESIDENT |
|---|---|
| Authorized Official Name | Peterson Jon Bradley |
| Telephone Number | 9529259550 |
NPI Number Detail
| NPI Number | 1871576306 |
|---|---|
| Provider Enumeration Date | 2005-11-29 |
| Last Updated Date | 2009-06-16 |
Provider Mailing Address Detail
| Address | 6533 Drew Ave S |
|---|---|
| City | Edina |
| State | Minnesota (MN) |
| Post Code | 554352103 |
| Phone Number | 9529259550 |
| Fax Number | 9529259748 |
Provider's Primary Taxonomy Detail
| Speciality | Eyewear Supplier |
|---|---|
| Taxonomy | 332H00000X |
|
Definition: An organization that provides spectacles, contact lenses, and other vision enhancement devices prescribed by an optometrist or ophthalmologist. |
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What is the unique identifier code issued to Southdale Optical Co by the Centers for Medicare & Medicaid Services (CMS)?
The Southdale Optical Co has been assigned the NPI (National Provider Identifier) 1871576306. This 10-digit code serves as a unique identification number for healthcare providers, issued by the CMS.
Can you provide the Southdale Optical Co's physical address?
The Southdale Optical Co is physically located at 6533 Drew Ave S, in the city of Edina, MN, with the postal code 554352103.
What is the Southdale Optical Co's area of specialization and corresponding taxonomy classification?
The Southdale Optical Co's specialty field is Eyewear Supplier, and it falls under the taxonomy code 332H00000X, which categorizes healthcare providers based on their specialties.
On what date was the 1871576306 assigned to Southdale Optical Co?
The Southdale Optical Co was issued its 1871576306 on 2005-11-29, which is the date when this unique identifier was assigned to the organization by the Centers for Medicare & Medicaid Services.
As of what date were the Southdale Optical Co's details last updated?
The information pertaining to the Southdale Optical Co, including its address, specialty, and other details, was most recently updated on 2009-06-16.