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NPI Code Detail

MEDICARE: ZURGICAL HAT, LLC

MEDICARE: ZURGICAL HAT, LLC
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1174400000XSpecialist119727CO

General Provider Information

NPI Number : 1053620831
Entity Type Code : Organization
Provider Name (Legal Business Name) : ZURGICAL HAT, LLC
Provider Business Mailing Address
First Line : PO BOX 76510
Second Line :
City : COLORADO SPRINGS
State : CO
Zip : 80970-6510
Country : US
Telephone Number : 719-638-8844
Fax Number : 719-638-8115
Provider Business Practice Location Address
First Line : 1322 N ACADEMY BLVD STE 204
Second Line :
City : COLORADO SPRINGS
State : CO
Zip : 80909-3320
Country : US
Telephone Number : 719-638-8844
Fax Number : 719-638-8115
Authorized Official
Title or Position : OWNER
Name : ALICE DUNGEN
Credential : CSFA
Telephone Number : 719-638-8844
Provider Enumeration Date : 09/28/2010
Last Update Date : 01/09/2017

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Directions to “ZURGICAL HAT, LLC ” Practice Location

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