Provider Demographics
NPI:1003987934
Name:ARAPAHOE LITTLETON OPTICAL INC
Entity Type:Organization
Organization Name:ARAPAHOE LITTLETON OPTICAL INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:MR
Authorized Official - First Name:ROBERT
Authorized Official - Middle Name:CECIL
Authorized Official - Last Name:HOGAN
Authorized Official - Suffix:
Authorized Official - Credentials:AMERICAN BOARD CERTI
Authorized Official - Phone:303-789-0654
Mailing Address - Street 1:601 E HAMPDEN AVE
Mailing Address - Street 2:#130
Mailing Address - City:ENGLEWOOD
Mailing Address - State:CO
Mailing Address - Zip Code:80113-2764
Mailing Address - Country:US
Mailing Address - Phone:303-789-0654
Mailing Address - Fax:303-781-2159
Practice Address - Street 1:601 E HAMPDEN AVE
Practice Address - Street 2:#130
Practice Address - City:ENGLEWOOD
Practice Address - State:CO
Practice Address - Zip Code:80113-2764
Practice Address - Country:US
Practice Address - Phone:303-789-0654
Practice Address - Fax:303-781-2159
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-11-13
Last Update Date:2008-08-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes156FX1800XEye and Vision Services ProvidersTechnician/TechnologistOpticianGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
CO0313490002Medicare NSC