Apolade INC
Optometrist in Maple Grove, MN. Organization (NPI-2).
NPI number1740313824
StatusActive
Last updated in NPPESDec 11, 2018
Details
- NPI
- 1740313824
- Entity type
- Organization (NPI-2)
- Legal business name
- Apolade INC
- Organization subpart
- No
- Enumeration date
- Mar 14, 2007
- Last updated
- Dec 11, 2018
Medicare and OIG
- Medicare enrolled (PECOS)
- Yes · PART B SUPPLIER - CLINIC/GROUP PRACTICE
- Can order and refer
- Not on the CMS order and referring list
- OIG exclusion list
- This NPI is not listed
CMS and OIG files of November 2026. PECOS lookup · OIG exclusion check
Taxonomy and licenses
| Taxonomy code | Description | License | State | Primary |
|---|---|---|---|---|
| 152W00000X | Optometrist | 2827 | MN | Yes |
Other names
- Costco Optical (Doing Business As)
Practice location
11330 Fountains DrMaple Grove, MN 55369-7200
Phone 763-494-8063 · Fax 763-494-8062
Mailing address
720 N 4th St Unit 704Minneapolis, MN 55401-1950
Phone 612-743-1400
Authorized official
Tim J Nelson
President
6127431400
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