Provider Demographics
NPI:1245696376
Name:ANFEALD LLC
Entity type:Organization
Organization Name:ANFEALD LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:VP/PRINCIPAL
Authorized Official - Prefix:
Authorized Official - First Name:ANDREW
Authorized Official - Middle Name:T
Authorized Official - Last Name:TROCCOLI
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:970-372-1131
Mailing Address - Street 1:PO BOX 1937
Mailing Address - Street 2:
Mailing Address - City:FORT COLLINS
Mailing Address - State:CO
Mailing Address - Zip Code:80522-1937
Mailing Address - Country:US
Mailing Address - Phone:970-372-1131
Mailing Address - Fax:866-641-7229
Practice Address - Street 1:320 E VINE DR
Practice Address - Street 2:SUITE 214
Practice Address - City:FORT COLLINS
Practice Address - State:CO
Practice Address - Zip Code:80524-2311
Practice Address - Country:US
Practice Address - Phone:970-372-1131
Practice Address - Fax:866-641-7229
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2016-01-05
Last Update Date:2016-01-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QC1800XAmbulatory Health Care FacilitiesClinic/CenterCorporate Health