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General NPI Number Information
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NPI Number | 1770805467
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Entity Type | Organization
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Legal Business Name | ARCHER MEDICAL
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Dates
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Enumeration Date | 02/22/2010
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Last Update Date | 05/24/2010
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Provider Practice Location Address
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Address Line | 4925 N UNION BLVD
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City | COLORADO SPRINGS
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State | CO
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Zip | 80918-4070
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Country | US
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Telephone | 719-637-0000
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Fax |
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Provider Business Mailing Address
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Address Line | 4925 N UNION BLVD
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City | COLORADO SPRINGS
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State | CO
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Zip | 80918-4070
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Country | US
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Telephone | 719-637-0000
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Fax |
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Authorized Official
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Title or Position | ADMINISTRATOR
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Name | ROBERT J RUZICKA
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Credential |
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Telephone | 719-637-0000
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 251E00000X
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Taxonomy Name | Home Health Agency
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License Number | 04L104
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License Number State | CO
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