Box Elder Family Vision
LBN: Larry D Terry A Professional Corporation
Box Elder Family Vision is an health care organization with primary practice located at 34 S Main St , Brigham City UT 84302-2527. The organization recently has 2 registered licenses in different health care specialties including Eye and Vision Services Providers / Optometrist, Suppliers / Eyewear Supplier (Equipment, not the service). Eye and Vision Services Providers / Optometrist is the primary health care specialty.
Larry D Terry A Professional Corporation can be contacted via phone (435) 723-2485, or through Terry, Larry Dean via phone (435) 723-2485.
Contact Information
Primary practice address
34 S Main St
Brigham City UT 84302-2527
Phone: (435) 723-2485
Fax: (435) 723-5840
Website:
Health care specialties
| Specialty | Code | License # | State |
|---|---|---|---|
| Eye and Vision Services Providers / Optometrist | 152W00000X | ||
| Suppliers / Eyewear Supplier (Equipment, not the service) | 332H00000X | 1125909934 | Utah |
Profile Details
| NPI number | 1811217383 |
|---|---|
| LBN Legal business name | Larry D Terry A Professional Corporation |
| DBA Doing business as | Box Elder Family Vision |
| Authorized official | Terry, Larry Dean Doctor of Optometry (OD) |
| Entity | Organization |
| Organization subpart 1 | No |
| Enumeration date | Jun 8th, 2010 |
| Last updated | Oct 2nd, 2019 - about 6 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.
Identifiers
| State | Type | Number | Issuer |
|---|---|---|---|
| All States | NPI | 1811217383 | NPPES |
| Utah | MEDICAID | 528920068006 |
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