Healthcare Provider Details

I. General information

NPI: 1609528348
Provider Name (Legal Business Name): A C ENTERPRISES, LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 01/24/2022
Last Update Date: 01/24/2022
Certification Date: 01/24/2022
Deactivation Date:
Reactivation Date:

III. Provider practice location address

5927 SPURWOOD DR
COLORADO SPRINGS CO
80918-8102
US

IV. Provider business mailing address

5927 SPURWOOD DR
COLORADO SPRINGS CO
80918-8102
US

V. Phone/Fax

Practice location:
  • Phone: 719-629-6796
  • Fax: 888-505-3617
Mailing address:
  • Phone: 719-629-6796
  • Fax: 888-505-3617

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code163WG0000X
TaxonomyGeneral Practice Registered Nurse
License Number
License Number State
# 2
Primary TaxonomyY
Taxonomy Code163WW0000X
TaxonomyWound Care Registered Nurse
License Number
License Number State

VIII. Authorized Official

Name: LYNN PEIER
Title or Position: OWNER
Credential:
Phone: 719-629-6796