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General NPI Number Information
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NPI Number | 1598928301
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Entity Type | Organization
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Legal Business Name | GENERALCARE HEALTH SERVICES
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Dates
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Enumeration Date | 07/02/2008
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Last Update Date | 07/02/2008
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Provider Practice Location Address
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Address Line | 620 S LEMAY AVE
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City | FORT COLLINS
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State | CO
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Zip | 80524-3543
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Country | US
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Telephone | 970-482-6620
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Fax | 970-482-6626
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Provider Business Mailing Address
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Address Line | 620 S LEMAY AVE
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City | FORT COLLINS
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State | CO
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Zip | 80524-3543
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Country | US
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Telephone | 970-482-6620
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Fax | 970-482-6626
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Authorized Official
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Title or Position | OFFICE ADMINISTRATOR
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Name | MS. LORI ANN VANSKIKE
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Credential |
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Telephone | 970-482-6620
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 261QX0100X
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Taxonomy Name | Occupational Medicine Clinic/Center
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License Number | 20945
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License Number State | CO
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