Executive Park Eye Care, Llc

LBN: Executive Park Eye Care, Pllc
Executive Park Eye Care, Llc is an health care organization with primary practice located at 9240 Explorer Dr Ste 100 , Colorado Springs CO 80920-5004. The organization recently has only one registered license in Eye and Vision Services Providers / Optometrist, which is considered as the primary health care specialty. Executive Park Eye Care, Pllc can be contacted via phone (719) 574-7000, or through Derber, Jeanne R via phone (719) 574-7000.

Contact Information

Primary practice address
9240 Explorer Dr Ste 100 Colorado Springs CO 80920-5004
Phone: (719) 574-7000
Fax: (719) 597-1712
Website:
Map and Directions
Authorized official contact:
Name: Derber, Jeanne R Doctor of Optometry (OD)
Phone: (719) 574-7000

Health care specialties

SpecialtyCodeLicense #State
Eye and Vision Services Providers / Optometrist 152W00000X

Profile Details

NPI number 1528156734
LBN Legal business name Executive Park Eye Care, Pllc
DBA Doing business as Executive Park Eye Care, Llc
Authorized official Derber, Jeanne R Doctor of Optometry (OD)
Entity Organization
Organization subpart 1 No
Enumeration date Oct 11th, 2006
Last updated Nov 2nd, 2021 - about 5 years ago

1 Some organizations, which are providing health care services, may consist of units or departments that provide different types of health care services or have several separate physical locations, where health care service is provided. These units, departments or physical locations are not themselves legal entities. However, each of them is part of the organization, which is a legal entity. The organization may decide whether its subparts, if it has any, should have their own NPI numbers. In case a subpart conducts any HIPAA standard transactions by itself, without its parent's involvement, it must have its own NPI number.

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Identifiers

StateTypeNumberIssuer
All States NPI 1528156734 NPPES
Colorado MEDICAID 27239721

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