Provider Demographics
NPI:1770505604
Name:PEAK WHEELCHAIRS, LLC
Entity Type:Organization
Organization Name:PEAK WHEELCHAIRS, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:MANGER/PRESIDENT
Authorized Official - Prefix:MR
Authorized Official - First Name:RICHARD
Authorized Official - Middle Name:D
Authorized Official - Last Name:SALM
Authorized Official - Suffix:
Authorized Official - Credentials:CRTS, ATS
Authorized Official - Phone:303-666-5150
Mailing Address - Street 1:275 WANEKA PKWY
Mailing Address - Street 2:SUITE 8
Mailing Address - City:LAFAYETTE
Mailing Address - State:CO
Mailing Address - Zip Code:80026-8873
Mailing Address - Country:US
Mailing Address - Phone:303-666-5150
Mailing Address - Fax:303-666-5958
Practice Address - Street 1:275 WANEKA PKWY
Practice Address - Street 2:SUITE 8
Practice Address - City:LAFAYETTE
Practice Address - State:CO
Practice Address - Zip Code:80026-8873
Practice Address - Country:US
Practice Address - Phone:303-666-5150
Practice Address - Fax:303-666-5958
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:PEAK GROUP, INC
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2006-07-23
Last Update Date:2008-03-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CON/A332BC3200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes332BC3200XSuppliersDurable Medical Equipment & Medical SuppliesCustomized Equipment
Provider Identifiers
StateIdentifier IDID TypeIssuer
CO08003725Medicaid
CO08003725Medicaid