Provider Demographics
NPI:1770246456
Name:MYEYES LLC
Entity type:Organization
Organization Name:MYEYES LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:DIRECTOR OF OPERATIONS
Authorized Official - Prefix:
Authorized Official - First Name:CHRIS
Authorized Official - Middle Name:
Authorized Official - Last Name:EPPERSON
Authorized Official - Suffix:
Authorized Official - Credentials:OMT,ESS-SM
Authorized Official - Phone:888-959-5563
Mailing Address - Street 1:361 N MILL RD
Mailing Address - Street 2:
Mailing Address - City:HEBER CITY
Mailing Address - State:UT
Mailing Address - Zip Code:84032-3128
Mailing Address - Country:US
Mailing Address - Phone:888-959-5563
Mailing Address - Fax:
Practice Address - Street 1:1901 PROSPECTOR AVE STE 29
Practice Address - Street 2:
Practice Address - City:PARK CITY
Practice Address - State:UT
Practice Address - Zip Code:84060-7320
Practice Address - Country:US
Practice Address - Phone:888-959-5563
Practice Address - Fax:435-292-1099
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2021-10-19
Last Update Date:2024-05-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes332B00000XSuppliersDurable Medical Equipment & Medical Supplies
Provider Identifiers
StateIdentifier IDID TypeIssuer
UT12332955-1714OtherUTAH STATE PHARM CLASS E, DME LICENSE
UT12287858-0161OtherUTAH DEPARTMENT OF COMMERCE, DIVISION OF CORPORATIONS AND COMMERCIAL CODE
UT136880OtherHEBER CITY BUSINESS LICENSE