MEDICARE: ROMANS EIGHT TWENTY EIGHT

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	332BX2000X	Oxygen Equipment & Supplies (DME)	4647410001	CO

General Provider Information

NPI Number	:	1841225265
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	ROMANS EIGHT TWENTY EIGHT

Provider Business Mailing Address
First Line	:	4223 W 38TH AVE
Second Line	:
City	:	DENVER
State	:	CO
Zip	:	80212-1925
Country	:	US
Telephone Number	:	303-961-4560
Fax Number	:	303-477-5609

Provider Business Practice Location Address
First Line	:	4223 W 38TH AVE
Second Line	:
City	:	DENVER
State	:	CO
Zip	:	80212-1925
Country	:	US
Telephone Number	:	303-861-4560
Fax Number	:

Authorized Official
Title or Position	:	OWNER
Name	:	MR. TERRY PERTEE
Credential	:
Telephone Number	:	303-861-4560

Provider Enumeration Date	:	07/12/2006
Last Update Date	:	03/26/2008

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Directions to “ROMANS EIGHT TWENTY EIGHT ” Practice Location

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