Organization
AMEDCO COLORADO PLLC
Active
Other names
St. Luke's Eye Care & Laser Center
Organization subpart
No
Provider details
NPI number
Authorized official
ERICA PERREIRA (CHIEF OPERATING OFFICER)
(877) 881-0022
Entity
Organization
Contact information
Practice address
1715 N WEBER ST, #360, COLORADO SPRINGS, CO 80907-7532
(719) 471-4000
(719) 632-6088
Mailing address
8076 W SAHARA AVE, LAS VEGAS, NV 89117-7930
(877) 881-0022
Taxonomy
Speciality
Code
Description
License number
State
152W00000X
Optometrist
—
—
207W00000X
Ophthalmology Physician
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
1306123096
UNITEDHEALTHCARE GROUP CONTRACT
CO
05
—
40322882
—
CO
Enumeration date
11/08/2011
Last updated
06/20/2018
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