Healthcare Provider Details

I. General information

NPI: 1881131852
Provider Name (Legal Business Name): MUSTARD SEED HEALTHCARE CONSULTING, LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 01/27/2017
Last Update Date: 06/18/2019
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1155 KELLY JOHNSON BLVD SUITE 111
COLORADO SPRINGS CO
80920-3932
US

IV. Provider business mailing address

1155 KELLY JOHNSON BLVD SUITE 111
COLORADO SPRINGS CO
80920-3932
US

V. Phone/Fax

Practice location:
  • Phone: 719-246-4243
  • Fax:
Mailing address:
  • Phone: 719-246-4243
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code341600000X
TaxonomyAmbulance
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code3416L0300X
TaxonomyLand Ambulance
License Number
License Number State
# 3
Primary TaxonomyN
Taxonomy Code343900000X
TaxonomyNon-emergency Medical Transport (VAN)
License Number
License Number State

VIII. Authorized Official

Name: MR. OSCAR OLIPANE
Title or Position: CEO
Credential:
Phone: 907-322-6171