Healthcare Provider Details

I. General information

NPI: 1255967345
Provider Name (Legal Business Name): USACS OF COLORADO INC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 03/20/2020
Last Update Date: 04/03/2025
Certification Date: 04/03/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

340 PEAK ONE DR
FRISCO CO
80443
US

IV. Provider business mailing address

4535 DRESSLER RD NW
CANTON OH
44718-2545
US

V. Phone/Fax

Practice location:
  • Phone: 844-474-4019
  • Fax:
Mailing address:
  • Phone: 844-474-4019
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207P00000X
TaxonomyEmergency Medicine Physician
License Number
License Number State

VIII. Authorized Official

Name: DOMINIC BAGNOLI
Title or Position: BOARD DIRECTOR
Credential:
Phone: 330-493-4443