Healthcare Provider Details

I. General information

NPI: 1972505113
Provider Name (Legal Business Name): PREFERRED HOMECARE OF COLORADO, LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 06/01/2005
Last Update Date: 03/04/2008
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

6900 W JEFFERSON AVE STE 125
LAKEWOOD CO
80235-2002
US

IV. Provider business mailing address

PO BOX 40700
MESA AZ
85274-0700
US

V. Phone/Fax

Practice location:
  • Phone: 303-783-1700
  • Fax: 303-788-0123
Mailing address:
  • Phone: 480-446-9010
  • Fax: 480-993-2033

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code332BP3500X
TaxonomyParenteral & Enteral Nutrition Supplies (DME)
License Number
License Number State
# 2
Primary TaxonomyY
Taxonomy Code332BX2000X
TaxonomyOxygen Equipment & Supplies (DME)
License Number
License Number State
# 3
Primary TaxonomyN
Taxonomy Code3336H0001X
TaxonomyHome Infusion Therapy Pharmacy
License Number
License Number State
# 4
Primary TaxonomyN
Taxonomy Code3336M0002X
TaxonomyMail Order Pharmacy
License Number
License Number State

VIII. Authorized Official

Name: TERI L JAMISON
Title or Position: GOVERNMENT COMPLIANCE MANAGER
Credential:
Phone: 480-446-9010