MEDICARE: PIONEER HOME MEDICAL SUPPLY LLC

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	332B00000X	Durable Medical Equipment & Medical Supplies
2	332BX2000X	Oxygen Equipment & Supplies (DME)

General Provider Information

NPI Number	:	1033124797
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	PIONEER HOME MEDICAL SUPPLY LLC

Provider Business Mailing Address
First Line	:	5357 HIGHWAY 86
Second Line	:	UNIT 4
City	:	ELIZABETH
State	:	CO
Zip	:	80107-7448
Country	:	US
Telephone Number	:	720-733-1403
Fax Number	:	720-733-1404

Provider Business Practice Location Address
First Line	:	5357 HIGHWAY 86
Second Line	:	UNIT 4
City	:	ELIZABETH
State	:	CO
Zip	:	80107-7448
Country	:	US
Telephone Number	:	720-733-1403
Fax Number	:	720-733-1404

Authorized Official
Title or Position	:	PRESIDENT
Name	:	MR. BROOKS C IMPERIAL
Credential	:
Telephone Number	:	720-733-1403

Provider Enumeration Date	:	07/30/2006
Last Update Date	:	09/11/2025

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