Provider Demographics
NPI:1376839597
Name:COLEMAN HEALTH LLC
Entity Type:Organization
Organization Name:COLEMAN HEALTH LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:ANNA
Authorized Official - Middle Name:L
Authorized Official - Last Name:SCHWARTZ
Authorized Official - Suffix:
Authorized Official - Credentials:PHD, FNP, FAAN
Authorized Official - Phone:307-413-2050
Mailing Address - Street 1:PO BOX 50146
Mailing Address - Street 2:
Mailing Address - City:PARKS
Mailing Address - State:AZ
Mailing Address - Zip Code:86018-0146
Mailing Address - Country:US
Mailing Address - Phone:307-413-2050
Mailing Address - Fax:
Practice Address - Street 1:3123 N SPRING VALLEY RD
Practice Address - Street 2:#50146
Practice Address - City:PARKS
Practice Address - State:AZ
Practice Address - Zip Code:86018-0146
Practice Address - Country:US
Practice Address - Phone:307-413-2050
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2011-06-27
Last Update Date:2018-05-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
261QP2300X
WY27354.1007363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes261QP2300XAmbulatory Health Care FacilitiesClinic/CenterPrimary CareGroup - Single Specialty
No363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamilyGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
WY1073656120OtherINDIVIDUAL NPI