Organization
ROCKY MOUNTAIN EYE CENTER INC A COLORADO PROVIDER NETWORK
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MS. ANN M HULETT (ADMINISTRATOR)
(719) 545-1530
Entity
Organization
Contact information
Practice address
1801 HOSPITAL DR, RATON, NM 87740-2032
(575) 445-2789
(575) 445-2780
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
Primary
—
—
332H00000X
Eyewear Supplier
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
200521004
MEDICARE
NM
01
—
85707368
NEW MEXICO MEDICAID
NM
01
—
CK7367
RAILROAD MEDICARE
NM
01
—
NM007E27
BCBS NEW MEXICO GROUP #
NM
Enumeration date
03/06/2007
Last updated
06/17/2009
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