Healthcare Provider Details

I. General information

NPI: 1730272733
Provider Name (Legal Business Name): COLORADO PROFESSIONAL MEDICAL
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 10/02/2006
Last Update Date: 02/15/2008
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2005 FRANKLIN ST STE 495
DENVER CO
80205-5401
US

IV. Provider business mailing address

2005 FRANKLIN ST SUITE 495
DENVER CO
80205-5401
US

V. Phone/Fax

Practice location:
  • Phone: 303-861-4592
  • Fax: 303-861-4338
Mailing address:
  • Phone: 303-232-2001
  • Fax: 303-233-6390

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code335E00000X
TaxonomyProsthetic/Orthotic Supplier
License Number
License Number State
# 2
Primary TaxonomyY
Taxonomy Code332B00000X
TaxonomyDurable Medical Equipment & Medical Supplies
License Number
License Number StateCO

VIII. Authorized Official

Name: SHERYL S PRICE
Title or Position: DIRECTOR OF REIMBURSEMENT
Credential:
Phone: 503-493-8288