1437471414 NPI number — ONE HOUR OPTICAL MEDICAL SERVICES, PC

Table of content: (NPI 1437471414)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1437471414 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:
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:
1437471414
Entity Type Code:
Organization
Replacement NPI:
Last Update Date:
02/19/2025
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:
8547 E ARAPAHOE RD
Provider Second Line Business Practice Location Address:
UNIT H
Provider Business Practice Location Address City Name:
GREENWOOD VILLAGE
Provider Business Practice Location Address State Name:
CO
Provider Business Practice Location Address Postal Code:
80112-1436
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
303-741-0446
Provider Business Practice Location Address Fax Number:
303-741-0827
Provider Enumeration Date:
02/18/2010

Additional Information

Authorized Official

Authorized Official Last Name:
ALLISON
Authorized Official First Name:
MELISSA
Authorized Official Middle Name:
Authorized Official Title or Position:
SR. DIRECTOR MVC
Authorized Official Telephone Number:
314-741-8183

Provider Taxonomy Codes

  • Taxonomy code: 152W00000X ; information, associated with the NPI states the following Primary Taxonomy Switch: "N" .
  • Taxonomy code: 152W00000X , with the licence number: 1746 , registered in the state of CO ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .

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

  • Identifier: 5668380003 . This is a "MEDICARE DME" identifier , issued by the state of ( CO ) . This identifiers is of the category "OTHER".
  • Identifier: 04209265 , issued by the state of ( CO ) . This identifiers is of the category "MEDICAID".
  • Identifier: S4503 . This is a "MEDICARE PTAN" identifier , issued by the state of ( CO ) . This identifiers is of the category "OTHER".




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