Provider Demographics
NPI:1629403076
Name:CHILDREN'S EYE PHYSICIANS
Entity Type:Organization
Organization Name:CHILDREN'S EYE PHYSICIANS
Other - Org Name:CHILDREN'S FAMILY OPTICAL
Other - Org Type:Doing Business As
Authorized Official - Title/Position:DIRECTOR OF FINANCE
Authorized Official - Prefix:
Authorized Official - First Name:CHERMAINE
Authorized Official - Middle Name:
Authorized Official - Last Name:SHEYKO
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:303-456-9456
Mailing Address - Street 1:4875 WARD RD
Mailing Address - Street 2:SUITE 600
Mailing Address - City:WHEAT RIDGE
Mailing Address - State:CO
Mailing Address - Zip Code:80033-1942
Mailing Address - Country:US
Mailing Address - Phone:303-456-9456
Mailing Address - Fax:303-467-0145
Practice Address - Street 1:4875 WARD RD
Practice Address - Street 2:SUITE 600
Practice Address - City:WHEAT RIDGE
Practice Address - State:CO
Practice Address - Zip Code:80033-1942
Practice Address - Country:US
Practice Address - Phone:303-456-9456
Practice Address - Fax:303-467-0145
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:CHILDREN'S EYE PHYSICIANS
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2013-09-04
Last Update Date:2013-09-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes332H00000XSuppliersEyewear Supplier