Healthcare Provider Details

I. General information

NPI: 1164337150
Provider Name (Legal Business Name): ELEVANCE MEDICAL LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 08/15/2026
Last Update Date: 08/15/2026
Certification Date: 08/15/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

7133 S DILLON CT
ENGLEWOOD CO
80112-4372
US

IV. Provider business mailing address

5753 S TRUCKEE ST
CENTENNIAL CO
80015-3095
US

V. Phone/Fax

Practice location:
  • Phone: 818-806-5233
  • 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: GALINA IZRAILBEKOVA
Title or Position: MANAGING MEMBER
Credential:
Phone: 818-806-5233