Healthcare Provider Details

I. General information

NPI: 1306461199
Provider Name (Legal Business Name): COLORADO EAR CARE LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 06/08/2020
Last Update Date: 08/12/2021
Certification Date: 08/12/2021
Deactivation Date:
Reactivation Date:

III. Provider practice location address

445 UNION BLVD STE 124
LAKEWOOD CO
80228-1239
US

IV. Provider business mailing address

445 UNION BLVD STE 124
LAKEWOOD CO
80228-1239
US

V. Phone/Fax

Practice location:
  • Phone: 303-233-3142
  • Fax: 303-233-3719
Mailing address:
  • Phone: 303-233-3142
  • Fax: 303-233-3719

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code231HA2400X
TaxonomyAssistive Technology Practitioner Audiologist
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code231HA2500X
TaxonomyAssistive Technology Supplier Audiologist
License Number
License Number State
# 3
Primary TaxonomyN
Taxonomy Code237600000X
TaxonomyAudiologist-Hearing Aid Fitter
License Number
License Number State
# 4
Primary TaxonomyY
Taxonomy Code231H00000X
TaxonomyAudiologist
License Number
License Number State

VIII. Authorized Official

Name: DR. MEREDITH HELEN WILKEN
Title or Position: OWNER
Credential: AUD
Phone: 303-549-7159