MEDICARE: MOBILE CARDIOLOGY SERVICES 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	246W00000X	Cardiology Technician

General Provider Information

NPI Number	:	1578596565
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	MOBILE CARDIOLOGY SERVICES INC

Provider Business Mailing Address
First Line	:	325 E LAUREL ST
Second Line	:
City	:	FORT COLLINS
State	:	CO
Zip	:	80524-3155
Country	:	US
Telephone Number	:	970-618-3468
Fax Number	:	970-797-2080

Provider Business Practice Location Address
First Line	:	325 E LAUREL ST
Second Line	:
City	:	FORT COLLINS
State	:	CO
Zip	:	80524-3155
Country	:	US
Telephone Number	:	970-618-3468
Fax Number	:	970-797-2080

Authorized Official
Title or Position	:	OWNER
Name	:	ANN COX
Credential	:	APRN
Telephone Number	:	970-618-3468

Provider Enumeration Date	:	07/10/2006
Last Update Date	:	08/08/2011

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