Provider Demographics
NPI:1275811523
Name:EDEN INTERNATIONAL, INC.
Entity Type:Organization
Organization Name:EDEN INTERNATIONAL, INC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT/ CHIEF SCIENTIFIC OFFICER
Authorized Official - Prefix:MRS
Authorized Official - First Name:DONALEE
Authorized Official - Middle Name:
Authorized Official - Last Name:PETERS
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:303-667-5114
Mailing Address - Street 1:10955 WESTMOOR DR
Mailing Address - Street 2:SUITE 400
Mailing Address - City:BROOMFIELD
Mailing Address - State:CO
Mailing Address - Zip Code:80021-2704
Mailing Address - Country:US
Mailing Address - Phone:303-667-5114
Mailing Address - Fax:303-379-2140
Practice Address - Street 1:10955 WESTMOOR DR
Practice Address - Street 2:SUITE 400
Practice Address - City:BROOMFIELD
Practice Address - State:CO
Practice Address - Zip Code:80021-2704
Practice Address - Country:US
Practice Address - Phone:303-667-5114
Practice Address - Fax:303-379-2140
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2011-08-03
Last Update Date:2011-08-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CO8223336C0004X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes3336C0004XSuppliersPharmacyCompounding Pharmacy