Provider Demographics
NPI:1275931370
Name:EYECARE SPECIALTIES INC.
Entity Type:Organization
Organization Name:EYECARE SPECIALTIES INC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:MR
Authorized Official - First Name:CRAIG
Authorized Official - Middle Name:TIMOTHY
Authorized Official - Last Name:ECKROTH
Authorized Official - Suffix:
Authorized Official - Credentials:OD
Authorized Official - Phone:970-824-3488
Mailing Address - Street 1:1111 W VICTORY WAY
Mailing Address - Street 2:SUITE 110
Mailing Address - City:CRAIG
Mailing Address - State:CO
Mailing Address - Zip Code:81625-2950
Mailing Address - Country:US
Mailing Address - Phone:970-824-3488
Mailing Address - Fax:970-824-8132
Practice Address - Street 1:1111 W VICTORY WAY
Practice Address - Street 2:SUITE 110
Practice Address - City:CRAIG
Practice Address - State:CO
Practice Address - Zip Code:81625-2950
Practice Address - Country:US
Practice Address - Phone:970-824-3488
Practice Address - Fax:970-824-8132
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2014-12-05
Last Update Date:2014-12-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes152W00000XEye and Vision Services ProvidersOptometristGroup - Single Specialty