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General NPI Number Information
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NPI Number | 1730619883
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Entity Type | Organization
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Legal Business Name | MOBILE HEALTH CARE
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Dates
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Enumeration Date | 06/12/2017
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Last Update Date | 06/11/2019
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Provider Practice Location Address
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Address Line | 4735 BYWOOD CT
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City | COLORADO SPRINGS
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State | CO
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Zip | 80906-5936
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Country | US
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Telephone | 719-238-7538
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Fax | 719-238-7538
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Provider Business Mailing Address
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Address Line | 4735 BYWOOD CT
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City | COLORADO SPRINGS
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State | CO
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Zip | 80906-5936
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Country | US
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Telephone | 719-238-7538
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Fax |
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Authorized Official
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Title or Position | OWNER
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Name | MRS. EILEEN ANN FLAVIN
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Credential | FNP
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Telephone | 719-238-7035
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 261QU0200X
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Taxonomy Name | Urgent Care Clinic/Center
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License Number | 102301
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License Number State | CO
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