Provider Demographics
NPI:1033414446
Name:CREATIVE TECHNOLOGY
Entity Type:Organization
Organization Name:CREATIVE TECHNOLOGY
Other - Org Name:CREATIVE TECHNOLOGY PROSTHETICS & ORTHOTICS
Other - Org Type:Doing Business As
Authorized Official - Title/Position:OFFICER
Authorized Official - Prefix:MR
Authorized Official - First Name:JASON
Authorized Official - Middle Name:
Authorized Official - Last Name:MUSGRAVE
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:303-346-1906
Mailing Address - Street 1:2425 S COLORADO BLVD
Mailing Address - Street 2:SUITE 100
Mailing Address - City:DENVER
Mailing Address - State:CO
Mailing Address - Zip Code:80222-5946
Mailing Address - Country:US
Mailing Address - Phone:303-346-1906
Mailing Address - Fax:303-962-1820
Practice Address - Street 1:8300 ALCOTT ST
Practice Address - Street 2:SUITE 105
Practice Address - City:WESTMINSTER
Practice Address - State:CO
Practice Address - Zip Code:80031-4008
Practice Address - Country:US
Practice Address - Phone:303-346-1906
Practice Address - Fax:303-962-1820
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2011-01-14
Last Update Date:2014-02-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes335E00000XSuppliersProsthetic/Orthotic Supplier
Provider Identifiers
StateIdentifier IDID TypeIssuer
CO26258064Medicaid
CO5563310002Medicare NSC