Provider Demographics
NPI:1285672261
Name:SCHRYVER MEDICAL SALES AND MARKETING LLC
Entity Type:Organization
Organization Name:SCHRYVER MEDICAL SALES AND MARKETING LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CEO
Authorized Official - Prefix:MR
Authorized Official - First Name:DOUG
Authorized Official - Middle Name:
Authorized Official - Last Name:GOETZ
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:303-371-0073
Mailing Address - Street 1:12075 E 45TH AVE
Mailing Address - Street 2:SUITE 600
Mailing Address - City:DENVER
Mailing Address - State:CO
Mailing Address - Zip Code:80239-3123
Mailing Address - Country:US
Mailing Address - Phone:303-371-0073
Mailing Address - Fax:303-785-9326
Practice Address - Street 1:12668 INTERURBAN AVE S.
Practice Address - Street 2:
Practice Address - City:TUKWILA
Practice Address - State:WA
Practice Address - Zip Code:98168-3314
Practice Address - Country:US
Practice Address - Phone:206-985-4000
Practice Address - Fax:206-985-3857
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-06-03
Last Update Date:2014-10-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WA602467854335V00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes335V00000XSuppliersPortable X-ray and/or Other Portable Diagnostic Imaging Supplier
Provider Identifiers
StateIdentifier IDID TypeIssuer
WA7128382Medicaid
WAG8854442Medicare PIN