Provider Demographics
NPI:1548389836
Name:PREFERRED MOBILE NURSES, INC.
Entity Type:Organization
Organization Name:PREFERRED MOBILE NURSES, INC.
Other - Org Name:PREFERRED HOME HEALTH; PREFERRED HOME CARE SERVICES
Other - Org Type:Doing Business As
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:PHILLIP
Authorized Official - Middle Name:E
Authorized Official - Last Name:PETTUS
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:303-263-1566
Mailing Address - Street 1:2802 MADISON SQUARE DRIVE
Mailing Address - Street 2:SUITE 100
Mailing Address - City:LOVELAND
Mailing Address - State:CO
Mailing Address - Zip Code:80538-3396
Mailing Address - Country:US
Mailing Address - Phone:970-776-1970
Mailing Address - Fax:970-776-1980
Practice Address - Street 1:2802 MADISON SQUARE DRIVE
Practice Address - Street 2:SUITE 100
Practice Address - City:LOVELAND
Practice Address - State:CO
Practice Address - Zip Code:80538-3396
Practice Address - Country:US
Practice Address - Phone:970-776-1970
Practice Address - Fax:970-776-1980
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-03-28
Last Update Date:2015-02-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
251E00000X
CO0403KK251E00000X
CO1003RW251E00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251E00000XAgenciesHome Health
Provider Identifiers
StateIdentifier IDID TypeIssuer
CO237581OtherGENTIVA-CARE CENTRIX
CO05700810Medicaid
CO170348OtherAPRIA HEALTHCARE
CO672650OtherBCBS-COLORADO
COAN91905740001OtherCIGNA
CO70682241Medicaid
CO72650OtherBCBS-FEDERAL
CO05700810Medicaid
COAN91905740001OtherCIGNA