Provider Demographics
NPI:1598574113
Name:EYE CARE ASSOCIATES OF CO, LLC
Entity type:Organization
Organization Name:EYE CARE ASSOCIATES OF CO, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:DIR RCM
Authorized Official - Prefix:
Authorized Official - First Name:DAVID
Authorized Official - Middle Name:
Authorized Official - Last Name:DEPPEN
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:937-539-8057
Mailing Address - Street 1:230 KINGS HWY E STE 333
Mailing Address - Street 2:
Mailing Address - City:HADDONFIELD
Mailing Address - State:NJ
Mailing Address - Zip Code:08033-1907
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:4557 MILLBRANCH RD STE 16
Practice Address - Street 2:
Practice Address - City:MEMPHIS
Practice Address - State:TN
Practice Address - Zip Code:38116-7437
Practice Address - Country:US
Practice Address - Phone:901-346-8222
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2025-01-07
Last Update Date:2025-01-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes152W00000XEye and Vision Services ProvidersOptometristGroup - Multi-Specialty