Provider Demographics
NPI:1730730870
Name:INTERIM HEALTHCARE OF FORT COLLINS, INC.
Entity type:Organization
Organization Name:INTERIM HEALTHCARE OF FORT COLLINS, INC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:ADMINISTRATOR
Authorized Official - Prefix:
Authorized Official - First Name:MARGY
Authorized Official - Middle Name:
Authorized Official - Last Name:BLOMBERG
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:970-472-4180
Mailing Address - Street 1:2000 VERMONT DR STE 100
Mailing Address - Street 2:
Mailing Address - City:FORT COLLINS
Mailing Address - State:CO
Mailing Address - Zip Code:80525-2900
Mailing Address - Country:US
Mailing Address - Phone:970-472-4180
Mailing Address - Fax:
Practice Address - Street 1:2000 VERMONT DR STE 100
Practice Address - Street 2:
Practice Address - City:FORT COLLINS
Practice Address - State:CO
Practice Address - Zip Code:80525-2900
Practice Address - Country:US
Practice Address - Phone:970-472-4180
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:INTERIM HEALTHCARE OF FORT COLLINS, INC.
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2019-09-20
Last Update Date:2020-06-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes253Z00000XAgenciesIn Home Supportive CareGroup - Multi-Specialty
No251E00000XAgenciesHome Health
No333300000XSuppliersEmergency Response System CompaniesGroup - Multi-Specialty
No3747P1801XNursing Service Related ProvidersTechnicianPersonal Care AttendantGroup - Multi-Specialty
No376J00000XNursing Service Related ProvidersHomemakerGroup - Multi-Specialty