PUEBLO CO OPHTHALMOLOGY ASC LLC NPI 1285608075

NPI Information

NPI: 1285608075
Provider Name: PUEBLO CO OPHTHALMOLOGY ASC LLC

Doing Business As: ROCKY MOUNTAIN LASER & SURGERY CENTER

Classification: Clinic/Center - 261QA1903X
Entity Type: Organization

Specialization: Ambulatory Surgical

Address:
1402 FORTINO BLVD
PUEBLO, CO
ZIP 81008
Phone: (719) 583-8700
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PUEBLO CO OPHTHALMOLOGY ASC LLC is an ambulatory surgical clinic center in Pueblo, CO. PUEBLO CO OPHTHALMOLOGY ASC LLC NPI is 1285608075. The provider is registered as an organization entity type.
The provider Is Doing Business As Rocky Mountain Laser & Surgery Center.

The provider's business location address is:

1402 FORTINO BLVD
PUEBLO, CO
ZIP 81008-033
Phone: (719) 583-8700
Fax: (719) 583-9700

The provider's authorized official is Jeffrey Snodgrass .
The authorized official title is President and has the following contact phone number (615) 665-1283.

The CLIA number assigned to this NPI record is 06D1016400 - ambulatory surgery center with a certificate type of Certificate of Waiver.

The enumeration date for this NPI number is 2/16/2006 and was last updated on 5/3/2022.

Taxonomy Codes

The NPI record includes the healthcare provider taxonomy classification, state license number and state of licensure. The following information regarding the scope of practice of this provider is available:

No.	Taxonomy Code	Taxonomy Clasification	Taxonomy Specialization	License Number	License State	Primary
1	261QA1903X	Clinic/Center	Ambulatory Surgical	208	COLORADO	Yes

Other Identifiers

The following information regarding additional identifiers associated to this NPI record includes the other identifier number, identifier type, identifier state and issuer.

No.	Other Provider Identifier	Other Provider Identifier Type	Other Provider Identifier State	Other Provider Identifier Issuer
1	90488032	MEDICAID	COLORADO

What is NPI?

NPI stands for National Provider Identifier. The NPI is a 10-digit identification number that is completely unique. The NPI number by itself does not contain any identifiable information such as a provider’s speciality or location. The NPI is assigned to individuals or organizacions for their lifespan and it is independent of key provider information type updates like a change of practices, location or speciality.

This page was last updated on: 4/28/2024

NPI Synchronization or Removal

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