Eye-Mart Factory Outlet

Primary specialty

Eyewear SupplierTaxonomy code 332H00000X

Legal business name

EYE-MART FACTORY OUTLET

Practice address

2139 N 12TH St
Unit 5
Grand Junction, CO 81501-2901

Phone

(970) 241-2020

Fax

(970) 241-7735

NPI assigned

Jan 3, 2008

Organization subpart

No

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name

Ms. Liz Anne Wicks

Title

Manager

Phone

(970) 241-2884

Specialties & licenses 1

Addresses

Other identifiers 1

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1199318400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1199318400000",
    "number": "1215112776",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2139 N 12TH ST",
            "address_2": "UNIT 5",
            "city": "GRAND JUNCTION",
            "state": "CO",
            "postal_code": "815012901",
            "telephone_number": "970-241-2020",
            "fax_number": "970-241-7735"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2139 N 12TH ST",
            "address_2": "UNIT 5",
            "city": "GRAND JUNCTION",
            "state": "CO",
            "postal_code": "815012901",
            "telephone_number": "970-241-2020",
            "fax_number": "970-241-7735"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "EYE-MART FACTORY OUTLET",
        "organizational_subpart": "NO",
        "enumeration_date": "2008-01-03",
        "last_updated": "2008-01-03",
        "status": "A",
        "authorized_official_last_name": "WICKS",
        "authorized_official_first_name": "LIZ",
        "authorized_official_middle_name": "ANNE",
        "authorized_official_title_or_position": "MANAGER",
        "authorized_official_telephone_number": "970-241-2884",
        "authorized_official_name_prefix": "Ms."
    },
    "taxonomies": [
        {
            "code": "332H00000X",
            "taxonomy_group": "",
            "desc": "Eyewear Supplier",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "COTP125233A",
            "state": "CO"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Evolve Behavioral Services, LLC
• Evolve Rides
• Courtney Ewing, PTA
• Exceptional Sleep Center of the Grand Valley LLC
• Eye Mart Outlet
• Eyemart Express LLC
• Eyemart Express LTD
• Eyes Only Vision Care LLC
• Daniel Lane Eyre, PHARMD
• David Bruce Faber, D.O.

• Eyewear Supplier in Grand Junction, CO
• Providers in Grand Junction, CO by specialty
• Eyewear Supplier in Colorado

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 3, 2008; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.