Healthcare Provider Details

I. General information

NPI: 1386528966
Provider Name (Legal Business Name): OMNICARE COLORADO LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 08/05/2025
Last Update Date: 08/05/2025
Certification Date: 08/05/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2821 S PARKER RD STE 559
AURORA CO
80014-2713
US

IV. Provider business mailing address

4370 BURTON WAY APT 422
COLORADO SPRINGS CO
80918-5945
US

V. Phone/Fax

Practice location:
  • Phone: 720-518-5231
  • Fax:
Mailing address:
  • Phone: 720-518-5231
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code251C00000X
TaxonomyDevelopmentally Disabled Services Day Training Agency
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code385H00000X
TaxonomyRespite Care
License Number
License Number State

VIII. Authorized Official

Name: BASIL MADANI
Title or Position: SOLE MEMBER
Credential:
Phone: 720-518-5231