SOUTHDALE OPTICAL CO – Eyewear Supplier, NPI 1871576306

SOUTHDALE OPTICAL CO is a healthcare provider. based in Edina, Minnesota. specializing in Eyewear Supplier. The NPI Number for SOUTHDALE OPTICAL CO is 1871576306

Main info

Organization
Name
SOUTHDALE OPTICAL CO
NPI
1871576306
Phone
(952) 925-9550
Address
6533 DREW AVE S
Authorized Official
MR. BRADLEY JON PETERSON PRESIDENT
Enumeration Date
29 November 2005
Last Update Date
16 June 2009
Data current as of
19 May 2026

Profile Insights

NPPES metrics only — not quality of care.

Methodology
Experience45
Completeness75
Years active:20State licenses:0Digital endpointsOther names

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Provider Addresses for SOUTHDALE OPTICAL CO

  • 6533, Drew Avenue South, Southdale, Edina, Hennepin County, Minnesota, 55435, United States

    EDINA, MN 554352103

    Phone: (952) 925-9550

    Fax: (952) 925-9748

    Mailing address matches the actual address.

NPPES updates history

No NPPES updates recorded for this provider.

Prescription Activity

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Open Payments (CMS)

No Open Payments data available for this provider.

This can happen when there are no reportable CMS Open Payments records.

Medicare Enrollment & Revalidation

Source: CMS public data · Not endorsed by CMS ·

Educational use only—not medical, billing, or legal advice.

No Medicare enrollment or revalidation data available for this provider in our database.

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Medicare Utilization (FFS)

Source: CMS public data · Not endorsed by CMS · Beneficiary counts under 11 are suppressed in source data ·

Educational use only—not medical, billing, or legal advice.

No Medicare fee-for-service utilization data available for this provider in our database.

Insurance plans in this area (ZIP 55435)

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Reviews

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Frequently asked questions

What is SOUTHDALE OPTICAL CO's NPI number?
SOUTHDALE OPTICAL CO's NPI is 1871576306 — the number used across U.S. healthcare to identify this provider.
Active or inactive — what applies to SOUTHDALE OPTICAL CO?
You should see SOUTHDALE OPTICAL CO as active in CMS-hosted NPPES data.
What kind of doctor is SOUTHDALE OPTICAL CO?
SOUTHDALE OPTICAL CO is associated with Eyewear Supplier in the directory — Clinical services aligned with this taxonomy classification.
What locale is associated with SOUTHDALE OPTICAL CO?
Directory geography for SOUTHDALE OPTICAL CO centers on Edina, Minnesota.
What does 2 location(s) imply?
2 practice locations appear in the available data.

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