Healthcare Provider Details

I. General information

NPI: 1437126950
Provider Name (Legal Business Name): INTERIM HEALTHCARE OF FORT COLLINS, INC.
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 03/02/2006
Last Update Date: 02/23/2016
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2000 VERMONT DR SUITE 100
FORT COLLINS CO
80525-2900
US

IV. Provider business mailing address

2000 VERMONT DR SUITE 100
FORT COLLINS CO
80525-2900
US

V. Phone/Fax

Practice location:
  • Phone: 970-472-4180
  • Fax: 970-472-4183
Mailing address:
  • Phone: 970-472-4180
  • Fax: 970-472-4183

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code251E00000X
TaxonomyHome Health Agency
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code253Z00000X
TaxonomyIn Home Supportive Care Agency
License Number1003YH
License Number StateCO

VIII. Authorized Official

Name: MRS. MARGY BLOMBERG
Title or Position: ADMINISTRATOR
Credential:
Phone: 970-472-4180