| Fort Morgan Eye Care Llc | |
|
1100 Main St Fort Morgan CO 80701-2036 | |
| (970) 867-3046 | |
| Not Available |
| Full Name | Fort Morgan Eye Care Llc |
|---|---|
| Speciality | Clinic/Center |
| Location | 1100 Main St, Fort Morgan, Colorado |
| Authorized Official Name and Position | Jeffrey Ryan Wiedrich (OPTOMETRIST) |
| Authorized Official Contact | 8063367105 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Fort Morgan Eye Care Llc 1100 Main St Fort Morgan CO 80701-2036 Ph: () - | Fort Morgan Eye Care Llc 1100 Main St Fort Morgan CO 80701-2036 Ph: (970) 867-3046 |
| NPI Number | 1093229718 |
|---|---|
| Provider Enumeration Date | 11/17/2017 |
| Last Update Date | 01/11/2018 |
| Medicare PECOS PAC ID | 3577822485 |
|---|---|
| Medicare Enrollment ID | O20180123002246 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1093229718 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 261Q00000X | Clinic/center | OPT.0002664 (Colorado) | Primary |
| Provider Name | Jeffrey Ryan Wiedrich |
|---|---|
| Provider Type | Practitioner - Optometry |
| Provider Identifiers | NPI Number: 1225287444 PECOS PAC ID: 9234379686 Enrollment ID: I20180123002359 |
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