Provider Demographics
NPI:1376214403
Name:DRAG BUNT HARTFORD, LLC
Entity Type:Organization
Organization Name:DRAG BUNT HARTFORD, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:MEMBER
Authorized Official - Prefix:
Authorized Official - First Name:DONALD
Authorized Official - Middle Name:
Authorized Official - Last Name:FERRARO
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:970-402-4231
Mailing Address - Street 1:2956 GINNALA DR STE 101
Mailing Address - Street 2:
Mailing Address - City:LOVELAND
Mailing Address - State:CO
Mailing Address - Zip Code:80538-7825
Mailing Address - Country:US
Mailing Address - Phone:970-402-4231
Mailing Address - Fax:
Practice Address - Street 1:305 W 5TH ST
Practice Address - Street 2:
Practice Address - City:HARTFORD
Practice Address - State:SD
Practice Address - Zip Code:57033-2275
Practice Address - Country:US
Practice Address - Phone:605-679-6668
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2021-09-28
Last Update Date:2021-09-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes310400000XNursing & Custodial Care FacilitiesAssisted Living Facility