Provider Demographics
NPI:1790879039
Name:INNOVATIVE SEATING
Entity Type:Organization
Organization Name:INNOVATIVE SEATING
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:GENERAL MANAGER
Authorized Official - Prefix:
Authorized Official - First Name:MICHELLE
Authorized Official - Middle Name:
Authorized Official - Last Name:RILEY
Authorized Official - Suffix:
Authorized Official - Credentials:RTS
Authorized Official - Phone:303-912-5898
Mailing Address - Street 1:9457 SOUTH UNIVERSITY BLVD STE 245
Mailing Address - Street 2:
Mailing Address - City:LITTLETON
Mailing Address - State:CO
Mailing Address - Zip Code:80126
Mailing Address - Country:US
Mailing Address - Phone:303-912-5898
Mailing Address - Fax:
Practice Address - Street 1:2200 SOUTH FOX STREET
Practice Address - Street 2:
Practice Address - City:DENVER
Practice Address - State:CO
Practice Address - Zip Code:80223
Practice Address - Country:US
Practice Address - Phone:303-912-5898
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-10-03
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CO4241657332BC3200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes332BC3200XSuppliersDurable Medical Equipment & Medical SuppliesCustomized Equipment