Provider Demographics
NPI:1518013820
Name:SF EYEWEAR INC
Entity Type:Organization
Organization Name:SF EYEWEAR INC
Other - Org Name:TAYLOR OPTICAL
Other - Org Type:Doing Business As
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:SHAWNDRA
Authorized Official - Middle Name:
Authorized Official - Last Name:FRASIER
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:801-278-0438
Mailing Address - Street 1:6556 S BIG COTTONWOOD CANYON RD # 400
Mailing Address - Street 2:
Mailing Address - City:SALT LAKE CITY
Mailing Address - State:UT
Mailing Address - Zip Code:84121-3580
Mailing Address - Country:US
Mailing Address - Phone:801-278-0438
Mailing Address - Fax:801-274-0175
Practice Address - Street 1:747 N 400 W
Practice Address - Street 2:
Practice Address - City:CENTERVILLE
Practice Address - State:UT
Practice Address - Zip Code:84014-1335
Practice Address - Country:US
Practice Address - Phone:801-278-0438
Practice Address - Fax:801-274-0175
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-01-27
Last Update Date:2010-03-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes332H00000XSuppliersEyewear Supplier