MEDICARE: COLORADO HAND THERAPY, 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	15162580000	CO

Other Identifiers

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

General Provider Information

NPI Number	:	1669797262
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	COLORADO HAND THERAPY, LLC

Provider Business Mailing Address
First Line	:	P.O. BOX 646
Second Line	:
City	:	CONIFER
State	:	CO
Zip	:	80433
Country	:	US
Telephone Number	:	303-777-0424
Fax Number	:	303-674-1993

Provider Business Practice Location Address
First Line	:	3045 WHITMAN DR
Second Line	:	SUITE 105
City	:	EVERGREEN
State	:	CO
Zip	:	80439-2210
Country	:	US
Telephone Number	:	303-777-0424
Fax Number	:	303-674-1993

Authorized Official
Title or Position	:	GENERAL MANAGER
Name	:	KARL R ZANDER
Credential	:
Telephone Number	:	303-777-0424

Provider Enumeration Date	:	04/07/2010
Last Update Date	:	10/15/2012

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