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General NPI Number Information
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NPI Number | 1851044010
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Entity Type | Organization
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Legal Business Name | COVID CARE ZONE INC
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Dates
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Enumeration Date | 01/28/2022
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Last Update Date | 01/28/2022
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Provider Practice Location Address
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Address Line | 5801 WASHINGTON AVE STE 203
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City | MOUNT PLEASANT
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State | WI
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Zip | 53406-4057
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Country | US
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Telephone | 224-607-4428
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Fax |
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Provider Business Mailing Address
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Address Line | 5801 WASHINGTON AVE STE 203
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City | MOUNT PLEASANT
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State | WI
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Zip | 53406-4057
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Country | US
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Telephone | 224-607-4428
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Fax |
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Authorized Official
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Title or Position | PRESIDENT
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Name | MOHAMMED INFAS ABDUL RAHMAN
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Credential |
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Telephone | 224-607-4428
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 291U00000X
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Taxonomy Name | Clinical Medical Laboratory
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License Number |
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License Number State |
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