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NPI Code Detail

MEDICARE: 2LAZY2, LLC

MEDICARE: 2LAZY2, LLC
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
1332H00000XEyewear Supplier

General Provider Information

NPI Number : 1932429982
Entity Type Code : Organization
Provider Name (Legal Business Name) : 2LAZY2, LLC
Provider Business Mailing Address
First Line : 2613 RED MOUNTAIN COURT
Second Line :
City : FORT COLLINS
State : CO
Zip : 80525
Country : US
Telephone Number : 970-231-3121
Fax Number : 970-488-1540
Provider Business Practice Location Address
First Line : 2613 RED MOUNTAIN CT
Second Line :
City : FORT COLLINS
State : CO
Zip : 80525-6160
Country : US
Telephone Number : 970-231-3121
Fax Number : 970-488-1540
Authorized Official
Title or Position : MANAGING MEMBER
Name : LYMON D CHASE
Credential :
Telephone Number : 970-231-3121
Provider Enumeration Date : 06/01/2010
Last Update Date : 06/01/2010

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Directions to “2LAZY2, LLC ” Practice Location

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