1477588044 NPI number — CLEAR VUE INC

Table of content: (NPI 1477588044)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1477588044 NPI number — CLEAR VUE INC

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
CLEAR VUE INC
Provider Last Name:
Provider First Name:
Provider Middle Name:
Provider Name Prefix Text:
Provider Name Suffix Text:
Provider Credential Text:
Provider Gender Code:

Provider's Other Name Information

Provider Other Organization Name:
Provider Other Organization Name Type Code:
6
Provider Other Last Name:
Provider Other First Name:
Provider Other Middle Name:
Provider Other Name Prefix Text:
Provider Other Name Suffix Text:
Provider Other Credential Text:
Provider Other Last Name Type Code:

NPI Number Information

NPI Number:
1477588044
Entity Type Code:
Organization
Replacement NPI:
Last Update Date:
06/03/2025
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
PO BOX 1140
Provider Second Line Business Mailing Address:
Provider Business Mailing Address City Name:
TOOELE
Provider Business Mailing Address State Name:
UT
Provider Business Mailing Address Postal Code:
84074-1140
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
435-843-8333
Provider Business Mailing Address Fax Number:
435-843-8334

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
2376 NORTH 400 EAST
Provider Second Line Business Practice Location Address:
BUILDING A SUITE 101
Provider Business Practice Location Address City Name:
TOOELE
Provider Business Practice Location Address State Name:
UT
Provider Business Practice Location Address Postal Code:
84074-9335
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
435-843-8333
Provider Business Practice Location Address Fax Number:
435-843-8334
Provider Enumeration Date:
07/12/2006

Additional Information

Authorized Official

Authorized Official Last Name:
GRIFFETH
Authorized Official First Name:
MICHAEL
Authorized Official Middle Name:
TODD
Authorized Official Title or Position:
OWNER
Authorized Official Telephone Number:
435-843-8333

Provider Taxonomy Codes

  • Taxonomy code: 207W00000X , with the licence number:  3089527-1205 , registered in the state of UT ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .

Other Provider's Identifiers (legacy, non-NPI)

  • Identifier: 2055676600 . This is a "DEPT. OF LABOR" identifier , issued by the state of ( UT ) . This identifiers is of the category "OTHER".
  • Identifier: 5277420001 . This is a "DMERC" identifier , issued by the state of ( UT ) . This identifiers is of the category "OTHER".
  • Identifier: 870672627GRI . This is a "EDUCATORS MUTUAL" identifier , issued by the state of ( UT ) . This identifiers is of the category "OTHER".
  • Identifier: 1574034 . This is a "CIGNA" identifier , issued by the state of ( UT ) . This identifiers is of the category "OTHER".
  • Identifier: QM0000059932 . This is a "ALTIUS" identifier , issued by the state of ( UT ) . This identifiers is of the category "OTHER".
  • Identifier: TPRA07984 , issued by the state of ( UT ) . This identifiers is of the category "MEDICAID".
  • Identifier: 107002804102 . This is a "SELECTHEALTH" identifier , issued by the state of ( UT ) . This identifiers is of the category "OTHER".
  • Identifier: TRICARE . This is a "870672627001" identifier , issued by the state of ( UT ) . This identifiers is of the category "OTHER".
  • Identifier: 51980339702001 , issued by the state of ( UT ) . This identifiers is of the category "MEDICAID".
  • Identifier: 51980339702001 . This is a "BCBS OF UT" identifier , issued by the state of ( UT ) . This identifiers is of the category "OTHER".
  • Identifier: 59154 . This is a "BCBS OF ID" identifier , issued by the state of ( ID ) . This identifiers is of the category "OTHER".




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