Active NPI
Mesabi Eyewear, Inc.
- Eyewear Supplier
- Virginia, MN
National Provider Identifier
1578753695
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Eyewear Supplier
- Legal business name
- MESABI EYEWEAR, INC.
- Practice address
- 104 N 3Rd Ave
Virginia, MN 55792-2519 - Phone
- (218) 749-2448
- Fax
- (218) 749-2448
- NPI assigned
- Jul 25, 2007
- Organization subpart
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Authorized official
- Name
- Ms. Shari Lynn Aubol
- Title
- Owner/Optician
- Phone
- (218) 749-2448
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Eyewear Supplier | 332H00000X | Primary |
Addresses
Primary practice location
104 N 3Rd Ave
Virginia, MN 55792-2519
Mailing address
104 N 3Rd Ave
Virginia, MN 55792-2519
Phone (218) 749-2448
Other identifiers 5
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 4C819ME | Other | MN | FIRST PLAN OF MINNESOTA/B |
| 1074070001 | Other | MN | UNICARE |
| 115136 | Other | MN | UCARE |
| 21-14110 | Other | MN | MEDICA |
| 212225100 | Medicaid | MN |
National Provider Directory
National Provider DirectoryLocations
104 N 3rd Ave
Virginia, MN 55792
Phone (218) 749-2448
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1185321600000",
"enumeration_type": "NPI-2",
"last_updated_epoch": "1212624000000",
"number": "1578753695",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "104 N 3RD AVE",
"city": "VIRGINIA",
"state": "MN",
"postal_code": "557922519",
"telephone_number": "218-749-2448",
"fax_number": "218-749-2448"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "104 N 3RD AVE",
"city": "VIRGINIA",
"state": "MN",
"postal_code": "557922519",
"telephone_number": "218-749-2448",
"fax_number": "218-749-2448"
}
],
"practiceLocations": [],
"basic": {
"organization_name": "MESABI EYEWEAR, INC.",
"organizational_subpart": "NO",
"enumeration_date": "2007-07-25",
"last_updated": "2008-06-05",
"status": "A",
"authorized_official_last_name": "AUBOL",
"authorized_official_first_name": "SHARI",
"authorized_official_middle_name": "LYNN",
"authorized_official_title_or_position": "OWNER/OPTICIAN",
"authorized_official_telephone_number": "218-749-2448",
"authorized_official_name_prefix": "Ms."
},
"taxonomies": [
{
"code": "332H00000X",
"taxonomy_group": "",
"desc": "Eyewear Supplier",
"state": null,
"license": null,
"primary": true
}
],
"identifiers": [
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "FIRST PLAN OF MINNESOTA/B",
"identifier": "4C819ME",
"state": "MN"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "UNICARE",
"identifier": "1074070001",
"state": "MN"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "UCARE",
"identifier": "115136",
"state": "MN"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "MEDICA",
"identifier": "21-14110",
"state": "MN"
},
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "212225100",
"state": "MN"
}
],
"endpoints": [],
"other_names": []
}
Other providers in Virginia, MN
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 5, 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.