Provider Demographics
NPI:1609819408
Name:PRAXAIR HEALTHCARE SERVICES, INC.
Entity Type:Organization
Organization Name:PRAXAIR HEALTHCARE SERVICES, INC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:SCOTT
Authorized Official - Middle Name:
Authorized Official - Last Name:KALTRIDER
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:203-837-2436
Mailing Address - Street 1:2011 CHERRY ST
Mailing Address - Street 2:UNIT 204
Mailing Address - City:LOUISVILLE
Mailing Address - State:CO
Mailing Address - Zip Code:80027-3090
Mailing Address - Country:US
Mailing Address - Phone:720-890-1400
Mailing Address - Fax:720-890-1422
Practice Address - Street 1:2704 S PRAIRIE AVE
Practice Address - Street 2:STE A
Practice Address - City:PUEBLO
Practice Address - State:CO
Practice Address - Zip Code:81005-3171
Practice Address - Country:US
Practice Address - Phone:719-543-4854
Practice Address - Fax:719-543-4886
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-06-13
Last Update Date:2009-12-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes332B00000XSuppliersDurable Medical Equipment & Medical Supplies
No332BC3200XSuppliersDurable Medical Equipment & Medical SuppliesCustomized Equipment
No332BP3500XSuppliersDurable Medical Equipment & Medical SuppliesParenteral & Enteral Nutrition
No332BX2000XSuppliersDurable Medical Equipment & Medical SuppliesOxygen Equipment & Supplies
Provider Identifiers
StateIdentifier IDID TypeIssuer
CO90581768Medicaid
CO90581768Medicaid