MEDICARE: COLORADO MEDICAL CONNECTIONS, LLC

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	332B00000X	Durable Medical Equipment & Medical Supplies	118151	CO

General Provider Information

NPI Number	:	1083850101
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	COLORADO MEDICAL CONNECTIONS, LLC

Provider Business Mailing Address
First Line	:	4332 RED ROCK DR
Second Line	:	SUITE A
City	:	LARKSPUR
State	:	CO
Zip	:	80118-8406
Country	:	US
Telephone Number	:	720-217-8129
Fax Number	:	303-681-3699

Provider Business Practice Location Address
First Line	:	4332 RED ROCK DR
Second Line	:	SUITE A
City	:	LARKSPUR
State	:	CO
Zip	:	80118-8406
Country	:	US
Telephone Number	:	720-217-8129
Fax Number	:	303-681-3699

Authorized Official
Title or Position	:	CFO/BUSINESS ACCOUNTS MANAGER
Name	:	MS. JENNIFER JEAN EDWARDS
Credential	:	RN
Telephone Number	:	720-217-8129

Provider Enumeration Date	:	12/18/2008
Last Update Date	:	12/18/2008

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