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HV PUEBLO SOUTH LLC NPI 1700247228


NPI Information

NPI: 1700247228
Provider Name: HV PUEBLO SOUTH LLC

Doing Business As: ACADEMY KIDS VISION

Classification: Clinic/Center - 261Q00000X
Entity Type: Organization
Address:
1725 S PUEBLO BLVD
PUEBLO, CO
ZIP 81005
Phone: (719) 281-2633
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HV PUEBLO SOUTH LLC is a clinic center in Pueblo, CO. The provider is a facility or distinct part of one used for the diagnosis and treatment of outpatients. Clinic/Center is irregularly defined, sometimes being limited to organizations serving specialized treatment requirements or distinct patient/client groups (e.g., radiology, poor, and public health). HV PUEBLO SOUTH LLC NPI is 1700247228. The provider is registered as an organization entity type and is a single specialty group.
The provider Is Doing Business As Academy Kids Vision.

The provider's business location address is:

1725 S PUEBLO BLVD
PUEBLO, CO
ZIP 81005-103
Phone: (719) 281-2633
Fax: (719) 281-2634

The provider's authorized official is Samantha B Leblanc .
The authorized official title is Credentialing Specialist and has the following contact phone number (719) 323-2372.

The enumeration date for this NPI number is 3/10/2016 and was last updated on 4/14/2021.


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 CodeTaxonomy ClasificationTaxonomy SpecializationLicense NumberLicense StatePrimary
1152W00000XOptometristNo
2261Q00000XClinic/CenterYes

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 IdentifierOther Provider Identifier TypeOther Provider Identifier StateOther Provider Identifier Issuer
168820071MEDICAIDCOLORADO

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: 11/14/2023

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