Healthcare Provider Details

I. General information

NPI: 1184453888
Provider Name (Legal Business Name): GLD CORP
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 07/31/2024
Last Update Date: 07/31/2024
Certification Date: 07/31/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

10371 PARKGLENN WAY STE 290
PARKER CO
80138-3879
US

IV. Provider business mailing address

10701 MILLIKEN ST
PARKER CO
80134-7632
US

V. Phone/Fax

Practice location:
  • Phone: 303-917-8205
  • Fax:
Mailing address:
  • Phone: 303-917-8205
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

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

VIII. Authorized Official

Name: KEVIN INSANA
Title or Position: OWNER
Credential:
Phone: 303-917-8205