Healthcare Provider Details

I. General information

NPI: 1962638940
Provider Name (Legal Business Name): NORTHERN COLORADO SLEEP CONSULTANTS, LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 06/04/2009
Last Update Date: 06/04/2009
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

4443 VISTA DR
FORT COLLINS CO
80526-3330
US

IV. Provider business mailing address

4443 VISTA DR
FORT COLLINS CO
80526-3330
US

V. Phone/Fax

Practice location:
  • Phone: 970-308-4495
  • Fax: 970-266-0555
Mailing address:
  • Phone: 970-308-4495
  • Fax: 970-266-0555

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code173F00000X
TaxonomySleep Specialist (PhD)
License Number
License Number State

VII. Legacy identifiers

For crosswalk purposes, the following legacy (non-NPI) identifiers are available for this provider:

VIII. Authorized Official

Name: DR. WILLIAM HERBERT MOORCROFT
Title or Position: CHIEF CONSULTANT
Credential: PHD
Phone: 970-308-4495