Provider Demographics
NPI:1174215131
Name:KOLOFON HEALTH LLC
Entity type:Organization
Organization Name:KOLOFON HEALTH LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:NATASHA
Authorized Official - Middle Name:
Authorized Official - Last Name:AJETI
Authorized Official - Suffix:
Authorized Official - Credentials:RN
Authorized Official - Phone:319-320-2138
Mailing Address - Street 1:155 MARION BLVD
Mailing Address - Street 2:
Mailing Address - City:MARION
Mailing Address - State:IA
Mailing Address - Zip Code:52302-3135
Mailing Address - Country:US
Mailing Address - Phone:319-320-2138
Mailing Address - Fax:
Practice Address - Street 1:155 MARION BLVD
Practice Address - Street 2:
Practice Address - City:MARION
Practice Address - State:IA
Practice Address - Zip Code:52302-3135
Practice Address - Country:US
Practice Address - Phone:319-320-2138
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2023-05-25
Last Update Date:2023-05-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251J00000XAgenciesNursing Care