Provider Demographics
NPI:1730619883
Name:MOBILE HEALTH CARE
Entity type:Organization
Organization Name:MOBILE HEALTH CARE
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:MRS
Authorized Official - First Name:EILEEN
Authorized Official - Middle Name:ANN
Authorized Official - Last Name:FLAVIN
Authorized Official - Suffix:
Authorized Official - Credentials:FNP
Authorized Official - Phone:719-238-7035
Mailing Address - Street 1:4735 BYWOOD CT
Mailing Address - Street 2:
Mailing Address - City:COLORADO SPRINGS
Mailing Address - State:CO
Mailing Address - Zip Code:80906-5936
Mailing Address - Country:US
Mailing Address - Phone:719-238-7538
Mailing Address - Fax:
Practice Address - Street 1:4735 BYWOOD CT
Practice Address - Street 2:
Practice Address - City:COLORADO SPRINGS
Practice Address - State:CO
Practice Address - Zip Code:80906-5936
Practice Address - Country:US
Practice Address - Phone:719-238-7538
Practice Address - Fax:719-238-7538
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2017-06-12
Last Update Date:2019-06-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CO102301261QU0200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QU0200XAmbulatory Health Care FacilitiesClinic/CenterUrgent Care