OPTIC SHOP, LLC. (NPI# 1396217931) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1396217931 |
| Entity Type | Organization |
| Organization Name | OPTIC SHOP, LLC. |
| Practice Address |
2205 W 8th St Coffeyville KS 67337-2936 |
| Practice Telephone | 6202510050 |
| Practice Fax Number | 6206886055 |
| Mailing Telephone | 6202510050 |
| Mailing Fax Number | 6206886055 |
| Enumeration Date | 2018-12-20 |
| Last Update Date | 2019-06-05 |
| Authorized Official Name | DR. HEATH V HAFFENER (PART OWNER) |
| Authorized Official Telephone | 6202528047 |
| Authorized Official Credential | D.C. |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 332H00000X | Eyewear Supplier (Equipment, not the service) | Suppliers |
| Address | Telephone Number | Fax Number |
|---|---|---|
| 1411 W 4th St, Coffeyville, KS 673373341 | 6202510050 | 6202510050 |
| Street Address |
2205 W 8TH ST |
| City | COFFEYVILLE |
| State | KS |
| Zip Code | 67337-2936 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1104819176 | Health Care Associates of Southeast Kansas, LLC | Nurse Practitioner | 2205 W 8th St, Coffeyville, KS 67337-2936 | 2005-08-25 |
| 1780771519 | Sharon R Marquez | Physical Therapist | 2205 W 8th St, Coffeyville, KS 67337-2936 | 2006-10-05 |
| 1255362513 | Advanced Pt Coffeyville LLC | Physical Therapist | 2205 W 8th St, Coffeyville, KS 67337-2936 | 2006-07-05 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1245858471 | Colby Robert Andreasen-cannon | Pharmacist | 1863 5300 Rd, Coffeyville, KS 67337 | 2020-07-14 |
| 1558917245 | Zachary James Newman | Case Manager/Care Coordinator | 1601 West 4th Street, Coffeyville, KS 67337 | 2019-08-18 |
| 1669725396 | Traeger Nelson Tvedten | Chiropractor | 411 1/2 West 11th Street, Coffeyville, KS 67337 | 2012-10-18 |
| 1831408020 | Carrie Lane Strimple | Family Medicine | 1505 W 11th St Ste C, Coffeyville, KS 67337 | 2010-10-05 |
| 1093047185 | Terry D Powell Radiation Oncologist, Inc. | Radiology | 1400 W 4th St, Radiation Oncology Dept, Coffeyville, KS 67337 | 2010-02-01 |
| 1649446931 | Windsor Place At Home Care LLC | Technician | 415 W 11th, Coffeyville, KS 67337 | 2008-05-06 |
| 1679668115 | Daniel H Chappell | Obstetrics & Gynecology | 801 W 8th St., Coffeyville, KS 67337 | 2006-10-03 |
| 1760582878 | Jack S Bell | Physician Assistant | 1411 W 4th, Suite G, Coffeyville, KS 67337 | 2006-09-25 |
| 1114026937 | Stephen A Miller | Obstetrics & Gynecology | 1717 West Eighth, Coffeyville, KS 67337 | 2006-09-21 |
| 1285600379 | Coffeyville Regional Medical Center, Inc. | General Acute Care Hospital | 1400 W 4th Street, Coffeyville, KS 67337 | 2006-02-27 |
| Find all providers in zip 67337 | ||||
| Taxonomy Code | 332H00000X |
| Grouping | Suppliers |
| Classification | Eyewear Supplier (Equipment, not the service) |
| An organization that provides spectacles, contact lenses, and other vision enhancement devices prescribed by an optometrist or ophthalmologist. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1821630187 | Eyemart Express LLC | Eyewear Supplier (Equipment, not the service) | 2540 Iowa St Ste K, Lawrence, KS 66046-5754 | 2019-10-08 |
| 1225595408 | Customeyes LLC | Eyewear Supplier (Equipment, not the service) | 1861 N Rock Rd Ste 214, Wichita, KS 67206-1264 | 2019-02-25 |
| 1598233652 | Svs Vision Inc | Eyewear Supplier (Equipment, not the service) | 6635 W 135th St, Overland Park, KS 66223-7898 | 2018-11-07 |
| 1699256271 | Eyemart Express LLC | Eyewear Supplier (Equipment, not the service) | 10231 W 21st St N # N107, Wichita, KS 67205-1832 | 2018-08-22 |
| 1821443250 | Visionworks Inc. | Eyewear Supplier (Equipment, not the service) | 1703 Village West Parkway, Suite 104, Kansas City, KS 66111-0000 | 2016-05-04 |
| 1982078085 | Eyemart Express LLC | Eyewear Supplier (Equipment, not the service) | 15206 W 119th St, Suite A, Olathe, KS 66062-5604 | 2015-11-30 |
| 1164819843 | Usv Optical Inc. | Eyewear Supplier (Equipment, not the service) | 330 Kansas Ave, Bldg. 700, Fort Leavenworth, KS 66027-1139 | 2015-04-21 |
| 1639437791 | Sunland Optical Co., Inc. | Eyewear Supplier (Equipment, not the service) | 330 Kansas Ave Bldg 700, Fort Leavenworth, KS 66027-1139 | 2012-04-26 |
| 1437439148 | Eyewear Junction LLC | Eyewear Supplier (Equipment, not the service) | 710 N Washington St, Junction City, KS 66441-2922 | 2011-08-25 |
| 1659501898 | Meadows-bell Opticians LLC | Eyewear Supplier (Equipment, not the service) | 8838 W 95th St, Overland Park, KS 66212-4051 | 2009-07-22 |
| Find all providers with the same taxonomy | ||||
| City | COFFEYVILLE |
| Zip Code | 67337 |
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| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.