MEDICARE: ANIMUS MEDICAL, 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

General Provider Information

NPI Number	:	1104200872
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	ANIMUS MEDICAL, LLC

Provider Business Mailing Address
First Line	:	8150 S AKRON ST
Second Line	:	#405
City	:	CENTENNIAL
State	:	CO
Zip	:	80112-3507
Country	:	US
Telephone Number	:	720-633-9089
Fax Number	:	720-633-9091

Provider Business Practice Location Address
First Line	:	8150 S AKRON ST
Second Line	:	#405
City	:	CENTENNIAL
State	:	CO
Zip	:	80112-3507
Country	:	US
Telephone Number	:	720-633-9089
Fax Number	:	720-633-9091

Authorized Official
Title or Position	:	GENERAL MANAGER
Name	:	DAVID CHALES HOFFMAN
Credential	:
Telephone Number	:	720-633-9089

Provider Enumeration Date	:	07/13/2015
Last Update Date	:	07/13/2015

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