Provider Demographics
NPI:1790980480
Name:J K HULLETT INCORPORATED
Entity Type:Organization
Organization Name:J K HULLETT INCORPORATED
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:KIMBERLY
Authorized Official - Middle Name:WARNER
Authorized Official - Last Name:HULLETT
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:303-786-9200
Mailing Address - Street 1:4895 RIVERBEND RD
Mailing Address - Street 2:SUITE B
Mailing Address - City:BOULDER
Mailing Address - State:CO
Mailing Address - Zip Code:80301-2640
Mailing Address - Country:US
Mailing Address - Phone:303-786-9200
Mailing Address - Fax:303-786-9300
Practice Address - Street 1:4895 RIVERBEND RD
Practice Address - Street 2:SUITE B
Practice Address - City:BOULDER
Practice Address - State:CO
Practice Address - Zip Code:80301-2640
Practice Address - Country:US
Practice Address - Phone:303-786-9200
Practice Address - Fax:303-786-9300
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-06-20
Last Update Date:2008-05-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes332BC3200XSuppliersDurable Medical Equipment & Medical SuppliesCustomized Equipment
Provider Identifiers
StateIdentifier IDID TypeIssuer
CO0983680001Medicare NSC