Provider Demographics
NPI:1457471690
Name:IDOX SYSTEM LLC
Entity Type:Organization
Organization Name:IDOX SYSTEM LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:MR
Authorized Official - First Name:IDOWU
Authorized Official - Middle Name:ISHOLA
Authorized Official - Last Name:OLADOYE
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:720-364-4979
Mailing Address - Street 1:444 S NOME WAY
Mailing Address - Street 2:
Mailing Address - City:AURORA
Mailing Address - State:CO
Mailing Address - Zip Code:80012-2244
Mailing Address - Country:US
Mailing Address - Phone:720-364-4979
Mailing Address - Fax:303-364-9204
Practice Address - Street 1:444 S NOME WAY
Practice Address - Street 2:
Practice Address - City:AURORA
Practice Address - State:CO
Practice Address - Zip Code:80012-2244
Practice Address - Country:US
Practice Address - Phone:720-364-4979
Practice Address - Fax:303-364-9204
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-03-30
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes343900000XTransportation ServicesNon-emergency Medical Transport (VAN)
Provider Identifiers
StateIdentifier IDID TypeIssuer
CO36708267Medicaid