Provider Demographics
NPI:1558548354
Name:RUNNING CREEK VISION CENTER, INC.
Entity Type:Organization
Organization Name:RUNNING CREEK VISION CENTER, INC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:CHRISTOPHER
Authorized Official - Middle Name:
Authorized Official - Last Name:THOMAS
Authorized Official - Suffix:
Authorized Official - Credentials:OD
Authorized Official - Phone:303-646-6911
Mailing Address - Street 1:537 PITKIN WAY
Mailing Address - Street 2:
Mailing Address - City:CASTLE ROCK
Mailing Address - State:CO
Mailing Address - Zip Code:80104-3269
Mailing Address - Country:US
Mailing Address - Phone:303-646-6911
Mailing Address - Fax:303-646-2113
Practice Address - Street 1:796 E. KIOWA AVE
Practice Address - Street 2:UNIT H-10
Practice Address - City:ELIZABETH
Practice Address - State:CO
Practice Address - Zip Code:80107
Practice Address - Country:US
Practice Address - Phone:303-646-6911
Practice Address - Fax:303-646-2113
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2008-01-24
Last Update Date:2011-04-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
COOPT2313152W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes152W00000XEye and Vision Services ProvidersOptometristGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
COCOA101245Medicare PIN