Avenue Vision, LLC
Organization Active NPI Vision Therapy Optometrist · Golden, CO
NPI 1134545882 · NPPES record last updated Mar 5, 2014
Key facts
- NPI
- 1134545882
- Entity type
- Organization (NPI type 2)
- Primary specialty
- Vision Therapy Optometrist 152WV0400X
- License
- 2748 (CO)
- Legal business name
- AVENUE VISION, LLC
- Practice address
- 1208 Washington Ave
Golden, CO 80401-1145 - Phone
- (303) 279-3713
- Fax
- (303) 273-5823
- NPI assigned
- Mar 5, 2014
- Organization subpart
- No
Authorized official
- Name
- Joseph F Borden, O.D.
- Title
- Optometrist/Owner
- Phone
- (303) 279-3713
Corporate family (same tax ID) 1
Practitioners 2
-
Megan Nicole Borden, O.D.
Medicare participation
- Medicare fee-for-service enrollment
- Enrolled in CO
Medicare enrollment records
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| O20150122000298 | CO | Part B Supplier - Clinic/Group Practice | 3971827940 |
Receives reassigned benefits from 2 practitioners Practice locations: Golden, CO |
National Provider Directory
- Tax ID family
- Avenue Vision LLC
Locations
1323 Washington Ave
Golden, CO 80401
Phone (303) 279-3713
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Vision Therapy Optometrist |
152WV0400X | 2748 | CO | Yes |
Addresses
Primary practice location
1208 Washington Ave
Golden, CO 80401-1145
Mailing address
1208 Washington Ave
Golden, CO 80401-1145
Phone (303) 279-3713
Other providers in Golden, CO
- Catherine Fallert Atkinson
- Leigh Atkinson
- Attuned Psychology, LLC
- Leslie Michelle Auer
- Arthur Charles Aughey
- Avenue Vision, LLC
- Karla Carolina Aviles
- Axcell Healthcare of Colorado
- Amanda Axman
- Steve Axtell
All providers in Golden, CO · Vision Therapy Optometrist in Colorado
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Mar 5, 2014. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- Medicare Fee-For-Service Public Provider Enrollment (CMS/PECOS): enrollments, PAC IDs and benefit reassignments.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.