Healthcare Provider Details

I. General information

NPI: 1578990156
Provider Name (Legal Business Name): B & B DME OF COLORADO
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 09/27/2013
Last Update Date: 09/27/2013
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

3360 ADOBE CT
COLORADO SPRINGS CO
80907-5462
US

IV. Provider business mailing address

3360 ADOBE CT
COLORADO SPRINGS CO
80907-5462
US

V. Phone/Fax

Practice location:
  • Phone: 719-232-5426
  • Fax:
Mailing address:
  • Phone: 719-232-5426
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code335E00000X
TaxonomyProsthetic/Orthotic Supplier
License NumberPTL.0007832
License Number StateCO

VIII. Authorized Official

Name: LORNE MACDONALD
Title or Position: GENERAL PARTNER
Credential: PT, DPT
Phone: 719-238-5426