MEDICARE: ERIE FAMILY OPTICAL LLC

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
1	332H00000X	Eyewear Supplier

General Provider Information

NPI Number	:	1871476804
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	ERIE FAMILY OPTICAL LLC

Provider Business Mailing Address
First Line	:	4875 WARD ROAD
Second Line	:	STE 600
City	:	WHEAT RIDGE
State	:	CO
Zip	:	80033-1944
Country	:	US
Telephone Number	:	303-463-9990
Fax Number	:	303-463-7563

Provider Business Practice Location Address
First Line	:	2400 VILLAGE VISTA DRIVE
Second Line	:
City	:	ERIE
State	:	CO
Zip	:	80516-4521
Country	:	US
Telephone Number	:	303-456-9456
Fax Number	:	303-467-0145

Authorized Official
Title or Position	:	PRACTICE ADMINISTRATOR/CEO
Name	:	LYNETTE BRIDGES
Credential	:
Telephone Number	:	303-463-5784

Provider Enumeration Date	:	07/28/2025
Last Update Date	:	07/28/2025

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Directions to “ERIE FAMILY OPTICAL LLC ” Practice Location

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