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
901 SELL AVE, CANON CITY, CO 81212-4900
(719) 275-7481
(719) 275-0059
Mailing address
27 MONTEBELLO RD, PUEBLO, CO 81001-1236
(719) 545-1530
(719) 545-2899
Taxonomy
Speciality
Code
Description
License number
State
152W00000X
Optometrist
Primary
—
—
207W00000X
Ophthalmology Physician
—
—
332H00000X
Eyewear Supplier
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
04009478
—
CO
01
—
608439600
U S DEPARTMENT OF LABOR
CO
01
—
CK2008
MEDICARE
CO
01
—
CQ2139
RAILROAD MEDICARE
CO
01
—
ROK2008
ANTHEM BLUE CROSS BLUE SH
CO
Enumeration date
12/15/2006
Last updated
12/18/2015
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