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NPI Code Detail

MEDICARE: USA MEDDAC FT CARSON, CO

MEDICARE: USA MEDDAC FT CARSON, CO
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
1286500000XMilitary Hospital116725CO

General Provider Information

NPI Number : 1730159062
Entity Type Code : Organization
Provider Name (Legal Business Name) : USA MEDDAC FT CARSON, CO
Provider Business Mailing Address
First Line : USA MEDDAC
Second Line : 1650 COCHRANE CIRCLE
City : FT. CARSON
State : CO
Zip : 80913
Country : US
Telephone Number : 719-526-7024
Fax Number : 716-524-4893
Provider Business Practice Location Address
First Line : 1650 COCHRANE CIR
Second Line :
City : FT CARSON
State : CO
Zip : 80913-4603
Country : US
Telephone Number : 719-260-7024
Fax Number : 719-524-4893
Authorized Official
Title or Position : CHIEF OF EDUCATION AND TRAINING
Name : MS. ELBA M D'ASARO
Credential : RN
Telephone Number : 719-526-7024
Provider Enumeration Date : 01/26/2006
Last Update Date : 08/22/2020

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