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General NPI Number Information
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NPI Number | 1598085664
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Entity Type | Organization
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Legal Business Name | COLORADO WOUND AND OSTOMY CARE, PC
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Dates
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Enumeration Date | 06/10/2010
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Last Update Date | 03/29/2016
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Provider Practice Location Address
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Address Line | 1601 LOWELL BLVD
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City | DENVER
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State | CO
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Zip | 80204-1545
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Country | US
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Telephone | 303-664-9400
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Fax |
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Provider Business Mailing Address
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Address Line | PO BOX 767
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City | LAFAYETTE
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State | CO
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Zip | 80026-0767
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Country | US
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Telephone | 303-664-9400
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Fax | 303-666-5362
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Authorized Official
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Title or Position | PRESIDENT
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Name | DR. GLENN E HERRMANN
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Credential | MD
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Telephone | 303-664-9400
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 174400000X
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Taxonomy Name | Specialist
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License Number | CO44716
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License Number State | CO
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