Healthcare Provider Details

I. General information

NPI: 1013812155
Provider Name (Legal Business Name): DJO, LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 10/09/2026
Last Update Date: 10/09/2026
Certification Date: 10/09/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

8 W DRY CREEK CIR STE 201
LITTLETON CO
80120-4477
US

IV. Provider business mailing address

8 W DRY CREEK CIR STE 201
LITTLETON CO
80120-4477
US

V. Phone/Fax

Practice location:
  • Phone: 704-749-6291
  • Fax: 844-277-2075
Mailing address:
  • Phone: 704-749-6291
  • Fax: 844-277-2075

VI. Provider taxonomy

Scope of Practice (Provider specialty)

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

VIII. Authorized Official

Name: MR. ANDRES MORENO III
Title or Position: BAS PRESIDENT
Credential:
Phone: 800-321-3549