Foothills Eye Clinic Llc | |
952 Swede Gulch Rd Evergreen CO 80439-3713 | |
(303) 526-0534 | |
Not Available |
Full Name | Foothills Eye Clinic Llc |
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Speciality | Clinic/Center |
Location | 952 Swede Gulch Rd, Evergreen, Colorado |
Authorized Official Name and Position | Brian Vincent (OWNER) |
Authorized Official Contact | 3036536255 |
Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
Mailing Address | Practice Location Address |
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Foothills Eye Clinic Llc Po Box 1530 Golden CO 80402-1530 Ph: (303) 653-6255 | Foothills Eye Clinic Llc 952 Swede Gulch Rd Evergreen CO 80439-3713 Ph: (303) 526-0534 |
NPI Number | 1336609957 |
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Provider Enumeration Date | 03/20/2019 |
Last Update Date | 04/26/2019 |
Medicare PECOS PAC ID | 4688917693 |
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Medicare Enrollment ID | O20190515000301 |
Identifier | Type | State | Issuer |
---|---|---|---|
1336609957 | NPI | - | NPPES |
Taxonomy | Type | License (State) | Status |
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261Q00000X | Clinic/center | (* (Not Available)) | Primary |
Provider Name | Brian Vincent |
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Provider Type | Practitioner - Optometry |
Provider Identifiers | NPI Number: 1194769844 PECOS PAC ID: 1052331113 Enrollment ID: I20051205000115 |
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