Provider Demographics
NPI:1578994299
Name:COLUMBINE MEDICAL EQUIPMENT, INC
Entity Type:Organization
Organization Name:COLUMBINE MEDICAL EQUIPMENT, INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CFO/COO
Authorized Official - Prefix:
Authorized Official - First Name:BARRY
Authorized Official - Middle Name:K
Authorized Official - Last Name:FANCHER
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:970-482-0198
Mailing Address - Street 1:1455 MAIN ST
Mailing Address - Street 2:SUITE 140
Mailing Address - City:WINDSOR
Mailing Address - State:CO
Mailing Address - Zip Code:80550-5559
Mailing Address - Country:US
Mailing Address - Phone:970-460-9205
Mailing Address - Fax:970-460-0436
Practice Address - Street 1:1525 MAIN ST UNIT B1B
Practice Address - Street 2:
Practice Address - City:WINDSOR
Practice Address - State:CO
Practice Address - Zip Code:80550-5997
Practice Address - Country:US
Practice Address - Phone:970-460-9205
Practice Address - Fax:970-460-0436
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:COLUMBINE MEDICAL EQUIPMENT, INC
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2013-12-05
Last Update Date:2019-11-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CO15130380000332B00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes332B00000XSuppliersDurable Medical Equipment & Medical Supplies