MEDICARE: FRENKEL INC.

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	261QS0132X	Ophthalmologic Surgery Clinic/Center	DR0055310	CO

General Provider Information

NPI Number	:	1033661228
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	FRENKEL INC.

Provider Business Mailing Address
First Line	:	3617 S COLLEGE AVE UNIT C
Second Line	:
City	:	FORT COLLINS
State	:	CO
Zip	:	80525-3009
Country	:	US
Telephone Number	:	970-377-0600
Fax Number	:	970-377-1818

Provider Business Practice Location Address
First Line	:	3617 S COLLEGE AVE UNIT C
Second Line	:
City	:	FORT COLLINS
State	:	CO
Zip	:	80525-3009
Country	:	US
Telephone Number	:	970-377-0600
Fax Number	:	970-377-1818

Authorized Official
Title or Position	:	OWNER
Name	:	RONALD BERT FRENKEL
Credential	:	M.D.
Telephone Number	:	970-377-0600

Provider Enumeration Date	:	11/04/2016
Last Update Date	:	11/04/2016

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