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NPI Code Detail

MEDICARE: ONE HOUR OPTICAL MEDICAL SERVICES, PC

MEDICARE: ONE HOUR OPTICAL MEDICAL SERVICES, PC
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
1152W00000XOptometrist

General Provider Information

NPI Number : 1811598360
Entity Type Code : Organization
Provider Name (Legal Business Name) : ONE HOUR OPTICAL MEDICAL SERVICES, PC
Provider Business Mailing Address
First Line : 211 E BROADWAY
Second Line :
City : ALTON
State : IL
Zip : 62002-6220
Country : US
Telephone Number : 618-462-9818
Fax Number :
Provider Business Practice Location Address
First Line : 8586 E ARAPAHOE RD STE 100
Second Line :
City : CENTENNIAL
State : CO
Zip : 80112-1433
Country : US
Telephone Number : 303-771-4221
Fax Number :
Authorized Official
Title or Position : CREDENTIALING MANAGER
Name : CATHY L. SHORT
Credential :
Telephone Number : 618-462-9818
Provider Enumeration Date : 11/02/2020
Last Update Date : 11/02/2020

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Directions to “ONE HOUR OPTICAL MEDICAL SERVICES, PC ” Practice Location

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