MEDICARE: TENDER CARE PEDIATRIC SERVICES, INC

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	:	1235855081
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	TENDER CARE PEDIATRIC SERVICES, INC

Provider Business Mailing Address
First Line	:	5677 BOEING DR
Second Line	:
City	:	LOVELAND
State	:	CO
Zip	:	80538-8811
Country	:	US
Telephone Number	:
Fax Number	:

Provider Business Practice Location Address
First Line	:	6021 WASHINGTON ST UNIT D
Second Line	:
City	:	DENVER
State	:	CO
Zip	:	80216-1153
Country	:	US
Telephone Number	:	720-722-9077
Fax Number	:

Authorized Official
Title or Position	:	CHIEF OPERATIONS OFFICER
Name	:	PAUL HOGFELDT
Credential	:
Telephone Number	:	970-686-5437

Provider Enumeration Date	:	10/13/2022
Last Update Date	:	10/13/2022

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