Provider Demographics
NPI:1598935462
Name:BLUE SKY MEDICAL
Entity Type:Organization
Organization Name:BLUE SKY MEDICAL
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PHYSICAN
Authorized Official - Prefix:
Authorized Official - First Name:DHRUV
Authorized Official - Middle Name:B
Authorized Official - Last Name:PATEDER
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:303-278-0392
Mailing Address - Street 1:607 10TH ST
Mailing Address - Street 2:SUITE 203
Mailing Address - City:GOLDEN
Mailing Address - State:CO
Mailing Address - Zip Code:80401-5817
Mailing Address - Country:US
Mailing Address - Phone:303-278-0392
Mailing Address - Fax:303-278-0612
Practice Address - Street 1:607 10TH ST
Practice Address - Street 2:SUITE 203
Practice Address - City:GOLDEN
Practice Address - State:CO
Practice Address - Zip Code:80401-5817
Practice Address - Country:US
Practice Address - Phone:303-278-0392
Practice Address - Fax:303-278-0612
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2008-03-07
Last Update Date:2008-03-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CO45892332B00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes332B00000XSuppliersDurable Medical Equipment & Medical Supplies