MEDICARE: SCHRYVER MEDICAL SALES AND MARKETING, 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	335V00000X	Portable X-ray and/or Other Portable Diagnostic Imaging Supplier

General Provider Information

NPI Number	:	1063890564
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	SCHRYVER MEDICAL SALES AND MARKETING, LLC

Provider Business Mailing Address
First Line	:	PO BOX 39931
Second Line	:
City	:	DENVER
State	:	CO
Zip	:	80239-0931
Country	:	US
Telephone Number	:	303-376-2716
Fax Number	:	303-785-9283

Provider Business Practice Location Address
First Line	:	6000 S EASTERN AVE
Second Line	:	SUITE 1-B
City	:	LAS VEGAS
State	:	NV
Zip	:	89119-3125
Country	:	US
Telephone Number	:	800-638-3240
Fax Number	:	303-576-7986

Authorized Official
Title or Position	:	CEO
Name	:	DOUG GOETZ
Credential	:
Telephone Number	:	303-371-0073

Provider Enumeration Date	:	05/15/2015
Last Update Date	:	01/04/2017

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