Provider Demographics
NPI:1487657292
Name:MCKINLEY MEDICAL LLC
Entity Type:Organization
Organization Name:MCKINLEY MEDICAL LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:INSURANCE BILLING MANAGER
Authorized Official - Prefix:
Authorized Official - First Name:JENNIFER
Authorized Official - Middle Name:
Authorized Official - Last Name:CONNER
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:303-420-9569
Mailing Address - Street 1:4080 YOUNGFIELD ST
Mailing Address - Street 2:
Mailing Address - City:WHEAT RIDGE
Mailing Address - State:CO
Mailing Address - Zip Code:80033-3862
Mailing Address - Country:US
Mailing Address - Phone:303-420-9569
Mailing Address - Fax:303-420-4545
Practice Address - Street 1:4080 YOUNGFIELD ST
Practice Address - Street 2:
Practice Address - City:WHEAT RIDGE
Practice Address - State:CO
Practice Address - Zip Code:80033-3862
Practice Address - Country:US
Practice Address - Phone:303-420-9569
Practice Address - Fax:303-420-4545
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2005-05-24
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CO15-13571-0000332B00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes332B00000XSuppliersDurable Medical Equipment & Medical Supplies