Provider Demographics
NPI:1295849537
Name:SCHRYVER MEDICAL SALES AND MARKETING INC.
Entity Type:Organization
Organization Name:SCHRYVER MEDICAL SALES AND MARKETING INC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER CEO
Authorized Official - Prefix:MR
Authorized Official - First Name:MARK
Authorized Official - Middle Name:RICHARD
Authorized Official - Last Name:SCHRYVER
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 1:6840 BROADWAY
Practice Address - Street 2:UNITS A-I
Practice Address - City:DENVER
Practice Address - State:CO
Practice Address - Zip Code:80221-2863
Practice Address - Country:US
Practice Address - Phone:303-650-5400
Practice Address - Fax:303-650-1881
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-08-17
Last Update Date:2007-09-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CO02748520000261QR0208X, 293D00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QR0208XAmbulatory Health Care FacilitiesClinic/CenterRadiology, Mobile
No293D00000XLaboratoriesPhysiological Laboratory
Provider Identifiers
StateIdentifier IDID TypeIssuer
CO20327889Medicaid
CO16-01019OtherEVERCARE
CO16-01019OtherEVERCARE