1770648297 NPI number — ONE HOUR OPTICAL MEDICAL SERVICES, PC

Table of content: (NPI 1770648297)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1770648297 NPI number — ONE HOUR OPTICAL MEDICAL SERVICES, PC

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
ONE HOUR OPTICAL MEDICAL SERVICES, PC
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:
ONE HOUR OPTICAL
Provider Other Organization Name Type Code:
3
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:
1770648297
Entity Type Code:
Organization
Replacement NPI:
Last Update Date:
09/24/2020
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
1685 S COLORADO BLVD
Provider Second Line Business Mailing Address:
UNIT O
Provider Business Mailing Address City Name:
DENVER
Provider Business Mailing Address State Name:
CO
Provider Business Mailing Address Postal Code:
80222-4000
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
303-757-6747
Provider Business Mailing Address Fax Number:
303-757-6897

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
1685 S COLORADO BLVD
Provider Second Line Business Practice Location Address:
UNIT O
Provider Business Practice Location Address City Name:
DENVER
Provider Business Practice Location Address State Name:
CO
Provider Business Practice Location Address Postal Code:
80222-4000
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
303-757-6747
Provider Business Practice Location Address Fax Number:
303-757-6897
Provider Enumeration Date:
12/26/2006

Additional Information

Authorized Official

Authorized Official Last Name:
HIEB
Authorized Official First Name:
STACY
Authorized Official Middle Name:
LYNN
Authorized Official Title or Position:
PRESIDENT
Authorized Official Telephone Number:
303-450-0200

Provider Taxonomy Codes

  • Taxonomy code: 152W00000X ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .

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

  • Identifier: 1013945112 . This is a "DR. ELIZABETH THOMAS, O.D." identifier , issued by the state of ( CO ) . This identifiers is of the category "OTHER".
  • Identifier: 1922406933 . This is a "DR. ROZALIYA SHIMONOVA, OD NPI" identifier , issued by the state of ( CO ) . This identifiers is of the category "OTHER".
  • Identifier: 04021879 , issued by the state of ( CO ) . This identifiers is of the category "MEDICAID".
  • Identifier: 1598775314 . This is a "DR. JOANN TAKARA, OD NPI" identifier , issued by the state of ( CO ) . This identifiers is of the category "OTHER".
  • Identifier: 1003223611 . This is a "DR. AMY ELSILA, OD NPI" identifier , issued by the state of ( CO ) . This identifiers is of the category "OTHER".
  • Identifier: 1548413040 . This is a "DR. AMANDA HANEY, OD NPI" identifier , issued by the state of ( CO ) . This identifiers is of the category "OTHER".
  • Identifier: 1548541972 . This is a "DR. HUGH MACMILLAN, OD NPI" identifier , issued by the state of ( CO ) . This identifiers is of the category "OTHER".
  • Identifier: 1619231800 . This is a "DR. AARON LAHOUD, OD NPI" identifier , issued by the state of ( CO ) . This identifiers is of the category "OTHER".
  • Identifier: C08407033 . This is a "MEDICARE SUBSCRIBER NUMBER" identifier , issued by the state of ( CO ) . This identifiers is of the category "OTHER".
  • Identifier: 1215317789 . This is a "DR. EMILY LEMBURG, OD NPI" identifier , issued by the state of ( CO ) . This identifiers is of the category "OTHER".
  • Identifier: 1669887600 . This is a "DR. TIMOTHY WHITMIRE, OD NPI" identifier , issued by the state of ( CO ) . This identifiers is of the category "OTHER".
  • Identifier: 1740369248 . This is a "DR STACY HIEB, OD NPI" identifier , issued by the state of ( CO ) . This identifiers is of the category "OTHER".




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