MEDICARE: NADINA MEDICAL SUPPLY 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	:	1437932225
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	NADINA MEDICAL SUPPLY LLC

Provider Business Mailing Address
First Line	:	1230 S PARKER RD STE 217
Second Line	:
City	:	DENVER
State	:	CO
Zip	:	80231-2119
Country	:	US
Telephone Number	:	303-728-9154
Fax Number	:	303-728-9154

Provider Business Practice Location Address
First Line	:	1230 S PARKER RD STE 217
Second Line	:
City	:	DENVER
State	:	CO
Zip	:	80231-2119
Country	:	US
Telephone Number	:	303-728-9154
Fax Number	:	303-728-9154

Authorized Official
Title or Position	:	C.E,O
Name	:	MOHAMED ELIAS OMER
Credential	:
Telephone Number	:	303-728-9154

Provider Enumeration Date	:	08/15/2023
Last Update Date	:	08/15/2023

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