Northwest Eyewear

LBN: Distinctive Eyewear, Llc
Northwest Eyewear is an health care organization with primary practice located at 12000 Elm Creek Blvd N Ste 100 , Maple Grove MN 55369-7074. The organization recently has 2 registered licenses in different health care specialties including Eye and Vision Services Providers / Optician, Suppliers / Eyewear Supplier (Equipment, not the service). Suppliers / Eyewear Supplier (Equipment, not the service) is the primary health care specialty. Distinctive Eyewear, Llc can be contacted via phone (763) 416-7653, or through Pettengill, Kelly via phone (763) 416-7629.

Contact Information

Primary practice address
12000 Elm Creek Blvd N Ste 100 Maple Grove MN 55369-7074
Phone: (763) 416-7653
Fax: (763) 416-7634
Website:
Map and Directions
Authorized official contact:
Name: Pettengill, Kelly
Phone: (763) 416-7629

Health care specialties

SpecialtyCodeLicense #State
Eye and Vision Services Providers / Optician 156FX1800X
Suppliers / Eyewear Supplier (Equipment, not the service) 332H00000X

Profile Details

NPI number 1043392632
LBN Legal business name Distinctive Eyewear, Llc
DBA Doing business as Northwest Eyewear
Authorized official Pettengill, Kelly
Entity Organization
Organization subpart 1 No
Enumeration date Oct 20th, 2006
Last updated Mar 18th, 2020 - about 5 years ago

1 Some organizations, which are providing health care services, may consist of units or departments that provide different types of health care services or have several separate physical locations, where health care service is provided. These units, departments or physical locations are not themselves legal entities. However, each of them is part of the organization, which is a legal entity. The organization may decide whether its subparts, if it has any, should have their own NPI numbers. In case a subpart conducts any HIPAA standard transactions by itself, without its parent's involvement, it must have its own NPI number.

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