Healthcare Provider Details

I. General information

NPI: 1609565126
Provider Name (Legal Business Name): GABRIEL MEDICAL, LLC.
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 05/01/2023
Last Update Date: 06/19/2023
Certification Date: 06/19/2023
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2020 S ONEIDA ST STE 14
DENVER CO
80224-2453
US

IV. Provider business mailing address

2020 S ONEIDA ST STE 14
DENVER CO
80224-2453
US

V. Phone/Fax

Practice location:
  • Phone: 303-731-1384
  • Fax: 303-731-6936
Mailing address:
  • Phone: 303-731-1384
  • Fax: 303-731-6936

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code332B00000X
TaxonomyDurable Medical Equipment & Medical Supplies
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code332BC3200X
TaxonomyCustomized Equipment (DME)
License Number
License Number State
# 3
Primary TaxonomyN
Taxonomy Code332BD1200X
TaxonomyDialysis Equipment & Supplies (DME)
License Number
License Number State
# 4
Primary TaxonomyN
Taxonomy Code332BP3500X
TaxonomyParenteral & Enteral Nutrition Supplies (DME)
License Number
License Number State

VIII. Authorized Official

Name: SIMAO C GABRIEL
Title or Position: CEO
Credential:
Phone: 303-731-1384