Provider Demographics
NPI:1639318488
Name:IT'S ME AGAIN OF COLORADO, INC
Entity Type:Organization
Organization Name:IT'S ME AGAIN OF COLORADO, INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:VICKIE
Authorized Official - Middle Name:L
Authorized Official - Last Name:BOHLENDER
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:970-613-1755
Mailing Address - Street 1:653 E EISENHOWER BLVD
Mailing Address - Street 2:
Mailing Address - City:LOVELAND
Mailing Address - State:CO
Mailing Address - Zip Code:80537-3919
Mailing Address - Country:US
Mailing Address - Phone:970-613-1755
Mailing Address - Fax:
Practice Address - Street 1:653 E EISENHOWER BLVD
Practice Address - Street 2:
Practice Address - City:LOVELAND
Practice Address - State:CO
Practice Address - Zip Code:80537-3919
Practice Address - Country:US
Practice Address - Phone:970-613-1755
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2009-02-17
Last Update Date:2009-04-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CO42-32987-0000332B00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes332B00000XSuppliersDurable Medical Equipment & Medical Supplies
Provider Identifiers
StateIdentifier IDID TypeIssuer
CO93422881Medicaid
CO6191930001Medicare NSC