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General NPI Number Information
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NPI Number | 1972737773
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Entity Type | Organization
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Legal Business Name | CASTLE PINES MEDICAL, INC.
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Dates
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Enumeration Date | 05/07/2009
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Last Update Date | 05/07/2009
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Provider Practice Location Address
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Address Line | 14883 E HINSDALE AVE SUITE 2
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City | CENTENNIAL
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State | CO
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Zip | 80112-6909
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Country | US
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Telephone | 303-442-4514
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Fax | 303-530-2610
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Provider Business Mailing Address
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Address Line | 14883 E HINSDALE AVE SUITE 2
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City | CENTENNIAL
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State | CO
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Zip | 80112-6909
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Country | US
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Telephone | 303-442-4514
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Fax | 303-530-2610
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Authorized Official
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Title or Position | PRESIDENT
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Name | MR. RODNEY NUSS
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Credential |
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Telephone | 303-442-4514
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 332BP3500X
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Taxonomy Name | Parenteral & Enteral Nutrition Supplies (DME)
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License Number | 35-11991-0000
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License Number State | CO
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