Healthcare Provider Details

I. General information

NPI: 1770014482
Provider Name (Legal Business Name): BLUE BEAR SERVICES LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 03/23/2017
Last Update Date: 03/23/2017
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

7302 S ALTON WAY STE D
CENTENNIAL CO
80112-2313
US

IV. Provider business mailing address

7302 S ALTON WAY STE D
CENTENNIAL CO
80112-2313
US

V. Phone/Fax

Practice location:
  • Phone: 303-459-6990
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code332B00000X
TaxonomyDurable Medical Equipment & Medical Supplies
License Number
License Number State

VIII. Authorized Official

Name: CHRISTOPHER BOYLE
Title or Position: PRESIDENT
Credential:
Phone: 303-459-6990