Provider Demographics
NPI:1265784656
Name:INFOCUS OPTICS LLC
Entity type:Organization
Organization Name:INFOCUS OPTICS LLC
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:MR
Authorized Official - First Name:MICHAEL
Authorized Official - Middle Name:T
Authorized Official - Last Name:GRIFFETH
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:435-830-9366
Mailing Address - Street 1:2376 N 400 E
Mailing Address - Street 2:SUITE 101
Mailing Address - City:TOOELE
Mailing Address - State:UT
Mailing Address - Zip Code:84074-3413
Mailing Address - Country:US
Mailing Address - Phone:435-843-8336
Mailing Address - Fax:435-843-8334
Practice Address - Street 1:2376 N 400 E
Practice Address - Street 2:SUITE 101
Practice Address - City:TOOELE
Practice Address - State:UT
Practice Address - Zip Code:84074-3413
Practice Address - Country:US
Practice Address - Phone:435-843-8336
Practice Address - Fax:435-843-8334
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2012-10-09
Last Update Date:2013-06-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
UT332B00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes332B00000XSuppliersDurable Medical Equipment & Medical Supplies
Provider Identifiers
StateIdentifier IDID TypeIssuer
UT6722120001Medicare NSC