Provider Demographics
NPI:1235797796
Name:ALTITUDE EYE CARE
Entity Type:Organization
Organization Name:ALTITUDE EYE CARE
Other - Org Name:ALTITUDE EYE CARE AT PARK MEADOWS
Other - Org Type:Doing Business As
Authorized Official - Title/Position:PARTNER
Authorized Official - Prefix:DR
Authorized Official - First Name:KRISTEN
Authorized Official - Middle Name:COLEEN
Authorized Official - Last Name:NICHOLSON
Authorized Official - Suffix:
Authorized Official - Credentials:OD
Authorized Official - Phone:303-649-9500
Mailing Address - Street 1:8405 PARK MEADOWS CENTER DR STE 1000
Mailing Address - Street 2:
Mailing Address - City:LONE TREE
Mailing Address - State:CO
Mailing Address - Zip Code:80124-5025
Mailing Address - Country:US
Mailing Address - Phone:303-649-9500
Mailing Address - Fax:303-649-9133
Practice Address - Street 1:8405 PARK MEADOWS CENTER DR STE 1000
Practice Address - Street 2:
Practice Address - City:LONE TREE
Practice Address - State:CO
Practice Address - Zip Code:80124-5025
Practice Address - Country:US
Practice Address - Phone:303-649-9500
Practice Address - Fax:303-649-9133
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2019-05-30
Last Update Date:2021-05-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes152W00000XEye and Vision Services ProvidersOptometristGroup - Single Specialty