Healthcare Provider Details
I. General information
NPI: 1891106985
Provider Name (Legal Business Name): FAMILY MEDICAL SUPPLY
Entity Type: Organization
Gender:
Sole Proprietor:
II. Dates (important events)
Enumeration Date: 05/12/2014
Last Update Date: 01/12/2026
Certification Date: 01/12/2026
Deactivation Date:
Reactivation Date:
III. Provider practice location address
1697 S FEDERAL BLVD
DENVER CO
80219
US
IV. Provider business mailing address
1697 S FEDERAL BLVD
DENVER CO
80219
US
V. Phone/Fax
- Phone: 720-216-1147
- Fax: 720-216-1571
- Phone: 720-216-1147
- Fax: 720-216-1571
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 | |
VIII. Authorized Official
Name:
VIEN
D
PHAM
Title or Position: OWNER
Credential:
Phone: 720-216-1147