MEDICARE: MCHUGH TILE & STONE

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	171WH0202X	Home Modifications Contractor

General Provider Information

NPI Number	:	1073227401
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	MCHUGH TILE & STONE

Provider Business Mailing Address
First Line	:	161 SATURN DR UNIT 1B
Second Line	:
City	:	FORT COLLINS
State	:	CO
Zip	:	80525-3953
Country	:	US
Telephone Number	:	970-797-6791
Fax Number	:

Provider Business Practice Location Address
First Line	:	161 SATURN DR UNIT 1B
Second Line	:
City	:	FORT COLLINS
State	:	CO
Zip	:	80525-3953
Country	:	US
Telephone Number	:	970-797-6791
Fax Number	:

Authorized Official
Title or Position	:	OWNER
Name	:	MATTHEW GREGORY MCHUGH
Credential	:
Telephone Number	:	970-797-6791

Provider Enumeration Date	:	01/10/2023
Last Update Date	:	01/20/2023

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Directions to “MCHUGH TILE & STONE ” Practice Location

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