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NPI Code Detail

MEDICARE: RED CLIFFS EYE CARE, INC.

MEDICARE: RED CLIFFS EYE CARE, INC.
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1152W00000XOptometrist1132139934UT

General Provider Information

NPI Number : 1740587625
Entity Type Code : Organization
Provider Name (Legal Business Name) : RED CLIFFS EYE CARE, INC.
Provider Business Mailing Address
First Line : 625 W TELEGRAPH ST
Second Line :
City : WASHINGTON
State : UT
Zip : 84780-1541
Country : US
Telephone Number : 435-986-3770
Fax Number : 435-986-3772
Provider Business Practice Location Address
First Line : 625 W TELEGRAPH ST
Second Line :
City : WASHINGTON
State : UT
Zip : 84780-1541
Country : US
Telephone Number : 435-986-3770
Fax Number : 435-986-3772
Authorized Official
Title or Position : PRESIDENT
Name : DR. JEFFERY J THATCHER
Credential : O.D.
Telephone Number : 435-986-3770
Provider Enumeration Date : 02/11/2011
Last Update Date : 02/11/2011

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Directions to “RED CLIFFS EYE CARE, INC. ” Practice Location

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