MEDICARE: ABUNDANT CONCEPTS 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	332BC3200X	Customized Equipment (DME)	44258	CO

General Provider Information

NPI Number	:	1245380757
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	ABUNDANT CONCEPTS INC

Provider Business Mailing Address
First Line	:	3361 N ACADEMY BLVD
Second Line	:
City	:	COLORADO SPRINGS
State	:	CO
Zip	:	80917-5103
Country	:	US
Telephone Number	:	719-597-1995
Fax Number	:	719-597-6113

Provider Business Practice Location Address
First Line	:	3361 N ACADEMY BLVD
Second Line	:
City	:	COLORADO SPRINGS
State	:	CO
Zip	:	80917-5103
Country	:	US
Telephone Number	:	719-597-1995
Fax Number	:	719-597-6113

Authorized Official
Title or Position	:	OWNER
Name	:	MR. TERRY CLEAVELAND
Credential	:
Telephone Number	:	719-597-1995

Provider Enumeration Date	:	01/10/2007
Last Update Date	:	08/22/2020

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