Healthcare Provider Details

I. General information

NPI: 1619643632
Provider Name (Legal Business Name): TECHNICAL RESOURCE MANAGEMENT LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 08/19/2021
Last Update Date: 04/11/2023
Certification Date: 04/11/2023
Deactivation Date:
Reactivation Date:

III. Provider practice location address

5604 FORTUNE CIR S STE N
INDIANAPOLIS IN
46241-5529
US

IV. Provider business mailing address

PO BOX 172775
DENVER CO
80217-2775
US

V. Phone/Fax

Practice location:
  • Phone: 855-895-8090
  • Fax: 303-371-0345
Mailing address:
  • Phone: 855-895-8090
  • Fax: 303-371-0345

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code291U00000X
TaxonomyClinical Medical Laboratory
License Number
License Number State

VIII. Authorized Official

Name: SYLVIA L FREEMAN
Title or Position: MANAGER OF CREDENTIALING AND ENROLL
Credential:
Phone: 508-304-7602