Organization
ROCKY MOUNTAIN EYE CENTER INC A COLORADO PROVIDER NETWORK
Active
Organization
ROCKY MOUNTAIN EYE CENTER INC A COLORADO PROVIDER NETWORK
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MR. DAVID ALDAG (ADMINISTRATOR)
(719) 545-1530
Entity
Organization
Contact information
Practice address
3954 SANDALWOOD LN, PUEBLO, CO 81005-2586
(719) 561-2244
(719) 561-9329
Mailing address
27 MONTEBELLO RD, PUEBLO, CO 81001-1236
(719) 545-1530
(719) 545-2899
Taxonomy
Speciality
Code
Description
License number
State
152W00000X
Optometrist
—
—
207W00000X
Ophthalmology Physician
—
—
332H00000X
Eyewear Supplier
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
04009478
—
CO
01
—
CK2008
MEDICARE
CO
01
—
CQ2139
RAILROAD MEDICARE
CO
01
—
ROK2008
ANTHEM BCBS
CO
Enumeration date
12/15/2006
Last updated
03/30/2015
Update your record
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