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General NPI Number Information
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NPI Number | 1740457472
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Entity Type | Organization
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Legal Business Name | INFINITY MEDICAL SUPPLY
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Dates
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Enumeration Date | 05/12/2008
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Last Update Date | 08/31/2012
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Provider Practice Location Address
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Address Line | 7079 S JORDAN RD #4
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City | CENTENNIAL
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State | CO
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Zip | 80112-3902
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Country | US
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Telephone | 303-521-3062
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Fax | 888-871-0236
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Provider Business Mailing Address
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Address Line | 7079 S JORDAN RD #4
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City | CENTENNIAL
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State | CO
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Zip | 80112-3902
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Country | US
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Telephone | 303-521-3062
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Fax | 888-871-0236
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Authorized Official
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Title or Position | OWNER
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Name | MAKSIM GREY
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Credential |
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Telephone | 303-521-3062
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 332BX2000X
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Taxonomy Name | Oxygen Equipment & Supplies (DME)
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License Number | 4261172
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License Number State | CO
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