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Contact Information

BALLANTYNE VISION CARE LLC
302 W 3RD ST
LA JUNTA, CO81050-1430
 Phone: 719-383-0134
 Fax: 719-404-1825
 Website:
 

Specialty

Taxonomy Code Specialty Code Provider Type

Optometrist

152W00000X 41 Optometry
Indicates primary specialty

NPI Profile & details for BALLANTYNE VISION CARE LLC

NPI Number 1306146121
LBN Legal business name BALLANTYNE VISION CARE LLC
Authorized official JORDAN BALLANTYNE - (OPTOMETRIST, OWNER)
Entity Organization
Organization subpart 1 No
Enumeration date 10/26/2010
Last updated 10/10/2016 - About 10 years ago
Identifiers
CO License # 2799
CO Medicaid 93920288
CO Other COA106109 MEDICARE GROUP PTAN
CO Other 1306146121 NPI FOR LAMAR OFFICE
1 Some organization health care providers are made up of components that furnish different types of health care or have separate physical locations where health care is furnished. These components and physical locations are not themselves legal entities, but are part of the organization health care provider (which is a legal entity). A covered organization provider may decide that its subparts (if it has any) should have their own NPI numbers. If a subpart conducts any HIPAA standard transactions on its own (e.g., separately from its parent), it must obtain its own NPI number.

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