Provider Demographics
NPI:1427718311
Name:CV EYECARE, LLC
Entity type:Organization
Organization Name:CV EYECARE, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OPTOMETRIST
Authorized Official - Prefix:
Authorized Official - First Name:CAM-VAN
Authorized Official - Middle Name:
Authorized Official - Last Name:LECARRELL
Authorized Official - Suffix:
Authorized Official - Credentials:OD
Authorized Official - Phone:803-457-1002
Mailing Address - Street 1:6429 FARTHING DRIVE, COLORADO SPRINGS CO 80906-7506
Mailing Address - Street 2:
Mailing Address - City:COLORADO SPRINGS
Mailing Address - State:CO
Mailing Address - Zip Code:80906
Mailing Address - Country:US
Mailing Address - Phone:803-457-1002
Mailing Address - Fax:
Practice Address - Street 1:9670 PROMINENT PT
Practice Address - Street 2:
Practice Address - City:COLORADO SPRINGS
Practice Address - State:CO
Practice Address - Zip Code:80924-5000
Practice Address - Country:US
Practice Address - Phone:719-495-0856
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2021-12-20
Last Update Date:2021-12-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes152W00000XEye and Vision Services ProvidersOptometristGroup - Single Specialty