Healthcare Provider Details

I. General information

NPI: 1063322550
Provider Name (Legal Business Name): EVERGREEN MEDICAL SUPPLIES INC.
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 09/09/2026
Last Update Date: 09/09/2026
Certification Date: 09/08/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1582 S PARKER RD STE 312
DENVER CO
80231-2714
US

IV. Provider business mailing address

1582 S PARKER RD STE 312
DENVER CO
80231-2714
US

V. Phone/Fax

Practice location:
  • Phone: 980-318-1375
  • 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: BASMA ALGBURI
Title or Position: OWNER
Credential:
Phone: 980-318-1375