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General NPI Number Information
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NPI Number | 1952712713
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Entity Type | Organization
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Legal Business Name | CNS HOLDING COMPANY LLC
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Dates
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Enumeration Date | 05/15/2014
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Last Update Date | 05/15/2014
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Provider Practice Location Address
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Address Line | 300 NW 1ST AVE
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City | WILLISTON
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State | FL
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Zip | 32696-2006
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Country | US
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Telephone | 352-529-0966
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Fax |
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Provider Business Mailing Address
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Address Line | 1300 SW 42ND ST
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City | OCALA
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State | FL
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Zip | 34471-1366
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Country | US
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Telephone |
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Fax |
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Authorized Official
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Title or Position | CEO
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Name | MR. FREDERICK C SPOGEN III
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Credential |
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Telephone | 352-572-0666
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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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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