Provider Demographics
NPI:1710074166
Name:ESSENTIAL MEDICAL SERVICES INC
Entity Type:Organization
Organization Name:ESSENTIAL MEDICAL SERVICES INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:ADMINISTRATOR
Authorized Official - Prefix:MRS
Authorized Official - First Name:DELORES
Authorized Official - Middle Name:R
Authorized Official - Last Name:PARDNER
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:303-873-0941
Mailing Address - Street 1:3000 S JAMAICA CT
Mailing Address - Street 2:175
Mailing Address - City:AURORA
Mailing Address - State:CO
Mailing Address - Zip Code:80014-4600
Mailing Address - Country:US
Mailing Address - Phone:303-873-0941
Mailing Address - Fax:303-873-0946
Practice Address - Street 1:3000 S JAMAICA CT
Practice Address - Street 2:175
Practice Address - City:AURORA
Practice Address - State:CO
Practice Address - Zip Code:80014-4600
Practice Address - Country:US
Practice Address - Phone:303-873-0941
Practice Address - Fax:303-873-0946
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-10-06
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CO251E00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251E00000XAgenciesHome Health
Provider Identifiers
StateIdentifier IDID TypeIssuer
CO05701537Medicaid
CO23202785Medicaid
CO067260Medicare ID - Type Unspecified