Healthcare Provider Details

I. General information

NPI: 1952827750
Provider Name (Legal Business Name): FAMILY FIRST VISION CARE COLORADO LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 08/14/2017
Last Update Date: 08/31/2022
Certification Date: 08/31/2022
Deactivation Date:
Reactivation Date:

III. Provider practice location address

14200 E ALAMEDA AVE
AURORA CO
80012-2511
US

IV. Provider business mailing address

316 S HAMILTON RD
GAHANNA OH
43230-3350
US

V. Phone/Fax

Practice location:
  • Phone: 303-344-2800
  • Fax: 303-344-2800
Mailing address:
  • Phone: 904-545-4465
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code152W00000X
TaxonomyOptometrist
License Number
License Number State

VIII. Authorized Official

Name: SARAH DOWLING
Title or Position: CREDENTIALING SPECIALIST
Credential:
Phone: 614-761-1255