Healthcare Provider Details
I. General information
NPI: 1861285256
Provider Name (Legal Business Name): CHERRY MEDICAL SUPPLY LLC
Entity Type: Organization
Gender:
Sole Proprietor:
II. Dates (important events)
Enumeration Date: 05/28/2025
Last Update Date: 05/29/2025
Certification Date: 05/29/2025
Deactivation Date:
Reactivation Date:
III. Provider practice location address
1842 S PARKER RD
DENVER CO
80231-2274
US
IV. Provider business mailing address
1842 S PARKER RD UNIT 23
DENVER CO
80231-2927
US
V. Phone/Fax
- Phone: 720-829-9083
- Fax:
- Phone:
- Fax:
VI. Provider taxonomy
Scope of Practice (Provider specialty)
| # 1 | |
| Primary Taxonomy | Y |
| Taxonomy Code | 332B00000X |
| Taxonomy | Durable Medical Equipment & Medical Supplies |
| License Number | |
| License Number State | |
| # 2 | |
| Primary Taxonomy | N |
| Taxonomy Code | 332BN1400X |
| Taxonomy | Nursing Facility Supplies (DME) |
| License Number | |
| License Number State | |
VIII. Authorized Official
Name:
LULIIA
VYSHNIAVSKA
Title or Position: CO OWNER-PARTNER
Credential:
Phone: 720-829-9083