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Organization
FAMILY EYE CLINIC, PC
Active
Organization
FAMILY EYE CLINIC, PC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MRS. SHAWN M. DEMOSS (PRACTICE MANAGER)
(303) 393-8378
Entity
Organization
Contact information
Practice address
6881 S YOSEMITE ST, CENTENNIAL, CO 80112-1406
(303) 393-8378
(720) 872-4902
Mailing address
6881 S YOSEMITE ST, CENTENNIAL, CO 80112-1406
(303) 393-8378
(720) 872-4902
Taxonomy
Speciality
Code
Description
License number
State
152WC0802X
Corneal and Contact Management Optometrist
Primary
—
NULL
152WC0802X
Corneal and Contact Management Optometrist
Primary
—
—
332H00000X
Eyewear Supplier
—
NULL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
46954333
—
CO
01
—
DD8301
RR MEDICARE
CO
01
—
PA666127
BCBS
CO
Enumeration date
03/22/2007
Last updated
07/12/2016
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