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General NPI Number Information
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NPI Number | 1871476804
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Entity Type | Organization
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Legal Business Name | ERIE FAMILY OPTICAL LLC
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Dates
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Enumeration Date | 07/28/2025
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Last Update Date | 07/28/2025
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Provider Practice Location Address
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Address Line | 2400 VILLAGE VISTA DRIVE
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City | ERIE
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State | CO
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Zip | 80516-4521
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Country | US
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Telephone | 303-456-9456
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Fax | 303-467-0145
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Provider Business Mailing Address
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Address Line | 4875 WARD ROAD STE 600
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City | WHEAT RIDGE
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State | CO
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Zip | 80033-1944
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Country | US
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Telephone | 303-463-9990
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Fax | 303-463-7563
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Authorized Official
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Title or Position | PRACTICE ADMINISTRATOR/CEO
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Name | LYNETTE BRIDGES
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Credential |
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Telephone | 303-463-5784
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 332H00000X
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Taxonomy Name | Eyewear Supplier
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License Number |
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License Number State |
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