Coffeyville Optic Shop LLC
NPI 1356005961ActiveOrganization· Technician/Technologist, Optician· Coffeyville, KS
Technician/Technologist, Optician in Coffeyville, Kansas, registered in NPPES in October 2021. The authorized official on file is Cynthia M. Dale, Owner. Enrolled in Medicare as dme supplier - optician.
Overview
| NPI | 1356005961 |
|---|---|
| Status | Active |
| Entity type | Organization |
| NPI issued | Oct 29, 2021 |
| Last updated in NPPES | Oct 29, 2021 |
| Certified by provider | Oct 29, 2021 |
Specialties and licenses
| Taxonomy | Code | License | State |
|---|---|---|---|
| Technician/Technologist, Optician Primary | 156FX1800X | — | — |
Exclusion screening
| List | Result | Details |
|---|---|---|
| HHS-OIG LEIE · Nov 10, 2026 | No match | Checked by NPI and by name + state |
| North Carolina Medicaid · Nov 11, 2026 | No match | — |
| New York OMIG · Nov 11, 2026 | No match | — |
| Ohio Medicaid · Nov 11, 2026 | No match | — |
| Pennsylvania Medicheck · Nov 11, 2026 | No match | — |
| Washington HCA · Nov 11, 2026 | No match | — |
Official OIG search · How matching works ·Bulk check a roster
Medicare
| Enrollment (PECOS) | Enrolled DME Supplier - Optician (KS) |
|---|
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