Healthcare Provider Details

I. General information

NPI: 1740017599
Provider Name (Legal Business Name): RIO EYECARE & CONTACT LENSES INC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 09/16/2024
Last Update Date: 09/16/2024
Certification Date: 09/16/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

8000 PASEO DEL NORTE NE BLDG E
ALBUQUERQUE NM
87122-2984
US

IV. Provider business mailing address

4100 CRESTVIEW DR SE
RIO RANCHO NM
87124-5942
US

V. Phone/Fax

Practice location:
  • Phone: 505-891-2020
  • Fax:
Mailing address:
  • Phone: 505-891-2020
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

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

VIII. Authorized Official

Name: CRAIG FREDERICK CLATANOFF
Title or Position: OWNER/OPTOMETRIST
Credential: OD
Phone: 505-891-2020