MEDICARE: VICAN MEDICAL,INC.

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy
1	332B00000X	Durable Medical Equipment & Medical Supplies
2	332H00000X	Eyewear Supplier
3	335V00000X	Portable X-ray and/or Other Portable Diagnostic Imaging Supplier
4	335E00000X	Prosthetic/Orthotic Supplier

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	:	1861453896
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	VICAN MEDICAL,INC.

Provider Business Mailing Address
First Line	:	2323 S TROY ST
Second Line	:	SUITE 3-105
City	:	AURORA
State	:	CO
Zip	:	80014-1946
Country	:	US
Telephone Number	:	303-306-1120
Fax Number	:	303-306-1134

Provider Business Practice Location Address
First Line	:	2323 S TROY ST
Second Line	:	SUITE 3-105
City	:	AURORA
State	:	CO
Zip	:	80014-1946
Country	:	US
Telephone Number	:	303-306-1120
Fax Number	:	303-306-1134

Authorized Official
Title or Position	:	PRESIDENT
Name	:	VITALIS CHINEDU NWAGWU
Credential	:
Telephone Number	:	303-306-1120

Provider Enumeration Date	:	03/29/2006
Last Update Date	:	09/11/2025

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Directions to “VICAN MEDICAL,INC. ” Practice Location

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