MEDICARE: EYE ASSOCIATES OF NEW MEXICO, LTD.

Medicare Provider Information

Scope of Practice

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

#	Taxonomy Code	Taxonomy
1	152W00000X	Optometrist
2	156FX1800X	Optician
3	207W00000X	Ophthalmology Physician
4	332B00000X	Durable Medical Equipment & Medical Supplies

Medicare Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
3	CH4370	OTHER	NM	RAILROAD MEDICARE (RRB)
4	CN6728	OTHER	NM	RAILROAD MEDICARE (RRB)

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program
2	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1609913482
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	EYE ASSOCIATES OF NEW MEXICO, LTD.

Provider Business Mailing Address
First Line	:	8801 HORIZON BLVD NE
Second Line	:	SUITE 360
City	:	ALBUQUERQUE
State	:	NM
Zip	:	87113-1533
Country	:	US
Telephone Number	:	505-246-2622
Fax Number	:	505-213-0103

Provider Business Practice Location Address
First Line	:	248 MILLS AVE
Second Line	:
City	:	LAS VEGAS
State	:	NM
Zip	:	87701-4125
Country	:	US
Telephone Number	:	505-426-8866
Fax Number	:	505-426-8601

Authorized Official
Title or Position	:	CHIEF ADMINISTRATIVE OFFICER
Name	:	CAROLE JEAN WRIGHT
Credential	:	CAO
Telephone Number	:	505-768-1335

Provider Enumeration Date	:	01/31/2007
Last Update Date	:	11/28/2007

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Directions to “EYE ASSOCIATES OF NEW MEXICO, LTD. ” Practice Location

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