Healthcare Provider Details

I. General information

NPI: 1265991681
Provider Name (Legal Business Name): OSTOMY, INCORPORATED
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 03/15/2019
Last Update Date: 03/29/2019
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

5314 MONTEBELLO LN
COLORADO SPRINGS CO
80918-1956
US

IV. Provider business mailing address

5314 MONTEBELLO LN
COLORADO SPRINGS CO
80918-1956
US

V. Phone/Fax

Practice location:
  • Phone: 719-985-7205
  • Fax: 719-344-5182
Mailing address:
  • Phone: 719-985-7205
  • Fax: 719-344-5182

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: JULIE EBEL GAREAU
Title or Position: PRESIDENT
Credential:
Phone: 954-975-8004