Provider Demographics
NPI:1457315467
Name:ABLE HEALTHCARE SUPPORT SERVICES, INC
Entity Type:Organization
Organization Name:ABLE HEALTHCARE SUPPORT SERVICES, INC
Other - Org Name:ABLE HEALTHCARE DME
Other - Org Type:Doing Business As
Authorized Official - Title/Position:CEO
Authorized Official - Prefix:MS
Authorized Official - First Name:SHAUNA
Authorized Official - Middle Name:DANIELLE
Authorized Official - Last Name:CARTER
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:303-344-3364
Mailing Address - Street 1:50 S HAVANA ST
Mailing Address - Street 2:STE 504
Mailing Address - City:AURORA
Mailing Address - State:CO
Mailing Address - Zip Code:80012
Mailing Address - Country:US
Mailing Address - Phone:303-344-3364
Mailing Address - Fax:303-344-8836
Practice Address - Street 1:50 S HAVANA ST
Practice Address - Street 2:STE 504
Practice Address - City:AURORA
Practice Address - State:CO
Practice Address - Zip Code:80012
Practice Address - Country:US
Practice Address - Phone:303-344-3364
Practice Address - Fax:303-344-8836
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-04-14
Last Update Date:2011-11-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes332B00000XSuppliersDurable Medical Equipment & Medical Supplies
Provider Identifiers
StateIdentifier IDID TypeIssuer
CO48639842Medicaid
5504320001Medicare ID - Type Unspecified