Provider Demographics
NPI:1346352366
Name:PROMED, INC.
Entity Type:Organization
Organization Name:PROMED, INC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:VICE PRESIDENT
Authorized Official - Prefix:MR
Authorized Official - First Name:WILLIAM
Authorized Official - Middle Name:
Authorized Official - Last Name:LOBOSCO
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:800-714-7434
Mailing Address - Street 1:695 S COLORADO BLVD
Mailing Address - Street 2:SUITE 200
Mailing Address - City:DENVER
Mailing Address - State:CO
Mailing Address - Zip Code:80246-8008
Mailing Address - Country:US
Mailing Address - Phone:303-744-2286
Mailing Address - Fax:303-744-2955
Practice Address - Street 1:695 S COLORADO BLVD
Practice Address - Street 2:SUITE 200
Practice Address - City:DENVER
Practice Address - State:CO
Practice Address - Zip Code:80246-8008
Practice Address - Country:US
Practice Address - Phone:303-744-2286
Practice Address - Fax:303-744-2955
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-08-31
Last Update Date:2016-03-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes332B00000XSuppliersDurable Medical Equipment & Medical Supplies
Provider Identifiers
StateIdentifier IDID TypeIssuer
CO08002438Medicaid
CO08002438Medicaid