Provider Demographics
NPI:1164017570
Name:SIMPLE OPTICAL, INC.
Entity Type:Organization
Organization Name:SIMPLE OPTICAL, INC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:PHILIP
Authorized Official - Middle Name:
Authorized Official - Last Name:WREN
Authorized Official - Suffix:
Authorized Official - Credentials:OD
Authorized Official - Phone:303-765-2020
Mailing Address - Street 1:2010 S UNIVERSITY BLVD
Mailing Address - Street 2:
Mailing Address - City:DENVER
Mailing Address - State:CO
Mailing Address - Zip Code:80210-4319
Mailing Address - Country:US
Mailing Address - Phone:303-765-2020
Mailing Address - Fax:303-698-2020
Practice Address - Street 1:2010 S UNIVERSITY BLVD
Practice Address - Street 2:
Practice Address - City:DENVER
Practice Address - State:CO
Practice Address - Zip Code:80210-4319
Practice Address - Country:US
Practice Address - Phone:303-765-2020
Practice Address - Fax:303-698-2020
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:SIMPLE OPTICAL, INC.
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2021-03-08
Last Update Date:2021-03-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes152W00000XEye and Vision Services ProvidersOptometristGroup - Single Specialty