Provider Demographics
NPI:1811501216
Name:ALDEN VISION LLC
Entity type:Organization
Organization Name:ALDEN VISION LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CEO
Authorized Official - Prefix:
Authorized Official - First Name:ASHLEY
Authorized Official - Middle Name:
Authorized Official - Last Name:ALDEN
Authorized Official - Suffix:
Authorized Official - Credentials:OD
Authorized Official - Phone:307-752-3184
Mailing Address - Street 1:5880 E 2ND ST STE 100
Mailing Address - Street 2:
Mailing Address - City:CASPER
Mailing Address - State:WY
Mailing Address - Zip Code:82609-4389
Mailing Address - Country:US
Mailing Address - Phone:307-472-2020
Mailing Address - Fax:307-237-2020
Practice Address - Street 1:5880 E 2ND ST STE 100
Practice Address - Street 2:
Practice Address - City:CASPER
Practice Address - State:WY
Practice Address - Zip Code:82609-4389
Practice Address - Country:US
Practice Address - Phone:307-472-2020
Practice Address - Fax:307-237-2020
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2020-09-02
Last Update Date:2020-09-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QH0100XAmbulatory Health Care FacilitiesClinic/CenterHealth Service