Healthcare Provider Details

I. General information

NPI: 1548765696
Provider Name (Legal Business Name): INTERIM HEALTHCARE OF SOUTHEASTERN COLORADO, INC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 03/29/2018
Last Update Date: 07/21/2022
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1901 N UNION BLVD STE 105
COLORADO SPRINGS CO
80909-7200
US

IV. Provider business mailing address

1901 N UNION BLVD STE 105
COLORADO SPRINGS CO
80909-7200
US

V. Phone/Fax

Practice location:
  • Phone: 719-314-4868
  • Fax:
Mailing address:
  • Phone: 719-314-4868
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207QH0002X
TaxonomyHospice and Palliative Medicine (Family Medicine) Physician
License Number36458
License Number StateCO

VIII. Authorized Official

Name: DEVIN RINGLING
Title or Position: CEO
Credential:
Phone: 719-632-9900