MEDICARE: ALLMARK MEDICAL, 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	:	1831494558
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	ALLMARK MEDICAL, LLC

Provider Business Mailing Address
First Line	:	PO BOX 1974
Second Line	:
City	:	MONUMENT
State	:	CO
Zip	:	80132-1974
Country	:	US
Telephone Number	:	719-599-3000
Fax Number	:

Provider Business Practice Location Address
First Line	:	860 COMMERCIAL LN
Second Line	:
City	:	PALMER LAKE
State	:	CO
Zip	:	80133-9037
Country	:	US
Telephone Number	:	719-599-3000
Fax Number	:

Authorized Official
Title or Position	:	OWNER
Name	:	MARK SMITH
Credential	:
Telephone Number	:	719-599-3000

Provider Enumeration Date	:	01/12/2011
Last Update Date	:	01/12/2011

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