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General NPI Number Information
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NPI Number | 1093300451
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Entity Type | Organization
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Legal Business Name | ZAPPCARE QOF LLC
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Dates
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Enumeration Date | 03/07/2021
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Last Update Date | 11/08/2021
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Provider Practice Location Address
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Address Line | 801 BURKE DR
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City | GALLUP
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State | NM
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Zip | 87301-5413
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Country | US
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Telephone | 505-300-2523
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Fax |
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Provider Business Mailing Address
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Address Line | 801 BURKE DR
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City | GALLUP
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State | NM
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Zip | 87301-5413
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Country | US
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Telephone | 505-300-2523
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Fax |
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Authorized Official
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Title or Position | CHIEF EXECUTIVE OFFICER
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Name | MARK ATLAN
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Credential |
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Telephone | 626-319-5445
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 163WD0400X
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Taxonomy Name | Diabetes Educator Registered Nurse
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License Number |
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License Number State |
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Taxonomy #2
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Taxonomy Code | 163WH0500X
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Taxonomy Name | Hemodialysis Registered Nurse
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License Number |
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License Number State |
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Taxonomy #3
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Taxonomy Code | 207W00000X
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Taxonomy Name | Ophthalmology Physician
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License Number |
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License Number State |
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Taxonomy #4
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Taxonomy Code | 261QE0700X
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Taxonomy Name | End-Stage Renal Disease (ESRD) Treatment Clinic/Center
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License Number |
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License Number State |
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Taxonomy #5
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Taxonomy Code | 261QU0200X
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Taxonomy Name | Urgent Care Clinic/Center
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License Number |
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License Number State |
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Taxonomy #6
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Taxonomy Code | 332800000X
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Taxonomy Name | Indian Health Service/Tribal/Urban Indian Health (I/T/U) Pharmacy
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License Number |
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License Number State |
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Taxonomy #7
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Taxonomy Code | 332U00000X
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Taxonomy Name | Home Delivered Meals
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License Number |
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License Number State |
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Taxonomy #8
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Taxonomy Code | 343900000X
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Taxonomy Name | Non-emergency Medical Transport (VAN)
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License Number |
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License Number State |
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Taxonomy #9
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Taxonomy Code | 261QR1300X
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Taxonomy Name | Rural Health Clinic/Center
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License Number |
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License Number State |
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