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NPI Code Detail

MEDICARE: ROTH MEDICAL INC

MEDICARE: ROTH MEDICAL 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
1332BC3200XCustomized Equipment (DME)
2332BP3500XParenteral & Enteral Nutrition Supplies (DME)
3332BX2000XOxygen Equipment & Supplies (DME)
4335E00000XProsthetic/Orthotic Supplier
5332B00000XDurable Medical Equipment & Medical Supplies

Other Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
1MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number : 1568423002
Entity Type Code : Organization
Provider Name (Legal Business Name) : ROTH MEDICAL INC
Provider Business Mailing Address
First Line : PO BOX 27968
Second Line :
City : SALT LAKE CITY
State : UT
Zip : 84127-0968
Country : US
Telephone Number : 765-448-6685
Fax Number : 765-446-4287
Provider Business Practice Location Address
First Line : 4715 TOWN CENTER DR
Second Line : SUITE A & B
City : COLORADO SPRINGS
State : CO
Zip : 80916-4702
Country : US
Telephone Number : 719-520-1414
Fax Number : 719-634-4002
Authorized Official
Title or Position : CHIEF EXECUTIVE OFFICER
Name : MRS. ROBIN L MENCHEN
Credential :
Telephone Number : 407-822-4600
Provider Enumeration Date : 03/31/2006
Last Update Date : 03/18/2024

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Directions to “ROTH MEDICAL INC ” Practice Location

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