Provider Demographics
NPI:1013548064
Name:ELEVATE MEDICAL SUPPLY LLC
Entity Type:Organization
Organization Name:ELEVATE MEDICAL SUPPLY LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CEO
Authorized Official - Prefix:
Authorized Official - First Name:OLUSESI
Authorized Official - Middle Name:
Authorized Official - Last Name:MAJEKODUNMI
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:303-734-7105
Mailing Address - Street 1:11001 W 120TH AVE STE 400
Mailing Address - Street 2:
Mailing Address - City:BROOMFIELD
Mailing Address - State:CO
Mailing Address - Zip Code:80021-3493
Mailing Address - Country:US
Mailing Address - Phone:303-734-7105
Mailing Address - Fax:
Practice Address - Street 1:11001 W 120TH AVE STE 400
Practice Address - Street 2:
Practice Address - City:BROOMFIELD
Practice Address - State:CO
Practice Address - Zip Code:80021-3493
Practice Address - Country:US
Practice Address - Phone:720-793-7552
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2020-01-29
Last Update Date:2020-04-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes332B00000XSuppliersDurable Medical Equipment & Medical Supplies