Provider Demographics
NPI:1598085664
Name:COLORADO WOUND AND OSTOMY CARE, PC
Entity Type:Organization
Organization Name:COLORADO WOUND AND OSTOMY CARE, PC
Other - Org Name:SLOANS LAKE WOUND CENTER
Other - Org Type:Doing Business As
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:GLENN
Authorized Official - Middle Name:E
Authorized Official - Last Name:HERRMANN
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:303-664-9400
Mailing Address - Street 1:PO BOX 767
Mailing Address - Street 2:
Mailing Address - City:LAFAYETTE
Mailing Address - State:CO
Mailing Address - Zip Code:80026-0767
Mailing Address - Country:US
Mailing Address - Phone:303-664-9400
Mailing Address - Fax:303-666-5362
Practice Address - Street 1:1601 LOWELL BLVD
Practice Address - Street 2:
Practice Address - City:DENVER
Practice Address - State:CO
Practice Address - Zip Code:80204-1545
Practice Address - Country:US
Practice Address - Phone:303-664-9400
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2010-06-10
Last Update Date:2016-03-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
COCO44716174400000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes174400000XOther Service ProvidersSpecialistGroup - Single Specialty