Provider Demographics
NPI:1578596565
Name:MOBILE CARDIOLOGY SERVICES INC
Entity Type:Organization
Organization Name:MOBILE CARDIOLOGY SERVICES INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:ANN
Authorized Official - Middle Name:
Authorized Official - Last Name:COX
Authorized Official - Suffix:
Authorized Official - Credentials:APRN
Authorized Official - Phone:970-618-3468
Mailing Address - Street 1:325 E LAUREL ST
Mailing Address - Street 2:
Mailing Address - City:FORT COLLINS
Mailing Address - State:CO
Mailing Address - Zip Code:80524-3155
Mailing Address - Country:US
Mailing Address - Phone:970-618-3468
Mailing Address - Fax:970-797-2080
Practice Address - Street 1:325 E LAUREL ST
Practice Address - Street 2:
Practice Address - City:FORT COLLINS
Practice Address - State:CO
Practice Address - Zip Code:80524-3155
Practice Address - Country:US
Practice Address - Phone:970-618-3468
Practice Address - Fax:970-797-2080
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-07-10
Last Update Date:2011-08-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes246W00000XTechnologists, Technicians & Other Technical Service ProvidersTechnician, CardiologyGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
COC803012Medicare PIN