Provider Demographics
NPI:1801833389
Name:SCHRYVER MEDICAL SALES AND MARKETING LLC
Entity Type:Organization
Organization Name:SCHRYVER MEDICAL SALES AND MARKETING LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CEO
Authorized Official - Prefix:MR
Authorized Official - First Name:DOUG
Authorized Official - Middle Name:
Authorized Official - Last Name:GOETZ
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:303-371-0073
Mailing Address - Street 1:12075 E 45TH AVE
Mailing Address - Street 2:SUITE 600
Mailing Address - City:DENVER
Mailing Address - State:CO
Mailing Address - Zip Code:80239-3123
Mailing Address - Country:US
Mailing Address - Phone:303-371-0073
Mailing Address - Fax:303-785-9326
Practice Address - Street 1:11585 E 53RD AVE
Practice Address - Street 2:UNIT H
Practice Address - City:DENVER
Practice Address - State:CO
Practice Address - Zip Code:80239-2330
Practice Address - Country:US
Practice Address - Phone:303-371-0073
Practice Address - Fax:303-785-9283
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-06-01
Last Update Date:2014-10-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CO02-74852-0000335V00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes335V00000XSuppliersPortable X-ray and/or Other Portable Diagnostic Imaging Supplier
Provider Identifiers
StateIdentifier IDID TypeIssuer
CO20327889Medicaid
CO630001643OtherRAILROAD MEDICARE
CO675809OtherBLUE CROSS
COC68333Medicare PIN