Healthcare Provider Details
I. General information
NPI: 1033713805
Provider Name (Legal Business Name): ALERACARE OF COLORADO, LLC
Entity Type: Organization
Gender:
Sole Proprietor:
II. Dates (important events)
Enumeration Date: 11/23/2020
Last Update Date: 10/07/2024
Certification Date: 10/07/2024
Deactivation Date:
Reactivation Date:
III. Provider practice location address
1303 FORTINO BLVD
PUEBLO CO
81008-2032
US
IV. Provider business mailing address
5350 E HIGH ST STE 300
PHOENIX AZ
85054-5561
US
V. Phone/Fax
- Phone: 888-209-8874
- Fax:
- Phone: 888-209-8874
- Fax:
VI. Provider taxonomy
Scope of Practice (Provider specialty)
| # 1 | |
| Primary Taxonomy | Y |
| Taxonomy Code | 261QM1300X |
| Taxonomy | Multi-Specialty Clinic/Center |
| License Number | |
| License Number State | |
VIII. Authorized Official
Name:
MARIANNE
LABARBERA
Title or Position: PRESIDENT
Credential: MD
Phone: 888-209-8874