Provider Demographics
NPI:1740056597
Name:UNITED OCULAR, LLC
Entity type:Organization
Organization Name:UNITED OCULAR, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:LJUBISA
Authorized Official - Middle Name:
Authorized Official - Last Name:ERNJAKOVIC
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:801-797-1778
Mailing Address - Street 1:7400 S UNION PARK AVE STE 102
Mailing Address - Street 2:
Mailing Address - City:MIDVALE
Mailing Address - State:UT
Mailing Address - Zip Code:84047-6705
Mailing Address - Country:US
Mailing Address - Phone:801-797-1778
Mailing Address - Fax:801-942-1717
Practice Address - Street 1:7400 S UNION PARK AVE STE 102
Practice Address - Street 2:
Practice Address - City:MIDVALE
Practice Address - State:UT
Practice Address - Zip Code:84047-6705
Practice Address - Country:US
Practice Address - Phone:801-797-1778
Practice Address - Fax:801-942-1717
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2023-12-01
Last Update Date:2024-01-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes332B00000XSuppliersDurable Medical Equipment & Medical SuppliesGroup - Multi-Specialty
No156FX1700XEye and Vision Services ProvidersTechnician/TechnologistOcularistGroup - Multi-Specialty