Provider Demographics
NPI:1942253653
Name:SAINT ANTHONY OPTICAL LTD.
Entity Type:Organization
Organization Name:SAINT ANTHONY OPTICAL LTD.
Other - Org Name:SAINT ANTHONY EYECARE ASSOC.
Other - Org Type:Doing Business As
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:MR
Authorized Official - First Name:RICHARD
Authorized Official - Middle Name:EARL
Authorized Official - Last Name:LAPPI
Authorized Official - Suffix:
Authorized Official - Credentials:COMT
Authorized Official - Phone:651-483-8148
Mailing Address - Street 1:PO BOX 130848
Mailing Address - Street 2:
Mailing Address - City:ROSEVILLE
Mailing Address - State:MN
Mailing Address - Zip Code:55113-0008
Mailing Address - Country:US
Mailing Address - Phone:651-483-8148
Mailing Address - Fax:651-483-3206
Practice Address - Street 1:2353 RICE ST
Practice Address - Street 2:STE. 206
Practice Address - City:ROSEVILLE
Practice Address - State:MN
Practice Address - Zip Code:55113-3739
Practice Address - Country:US
Practice Address - Phone:651-483-8148
Practice Address - Fax:651-483-3206
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-05-17
Last Update Date:2007-08-31
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MN2594152W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes152W00000XEye and Vision Services ProvidersOptometristGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
MN152713400Medicaid
MN16534OtherHEALTH PARTNERS
MN54839ANOtherBLUE CROSS BLUE SHIELD
MN152713400Medicaid
0642680001Medicare NSC