Provider Demographics
NPI:1891924890
Name:MODERNMED SUPPLIES, LLC
Entity Type:Organization
Organization Name:MODERNMED SUPPLIES, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:MR
Authorized Official - First Name:JOSEPH
Authorized Official - Middle Name:WILLIAM
Authorized Official - Last Name:SARTO
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:720-936-9554
Mailing Address - Street 1:10176 PARK MEADOWS DR
Mailing Address - Street 2:2208
Mailing Address - City:LONE TREE
Mailing Address - State:CO
Mailing Address - Zip Code:80124-8411
Mailing Address - Country:US
Mailing Address - Phone:720-936-9554
Mailing Address - Fax:
Practice Address - Street 1:10176 PARK MEADOWS DR
Practice Address - Street 2:2208
Practice Address - City:LONE TREE
Practice Address - State:CO
Practice Address - Zip Code:80124-8411
Practice Address - Country:US
Practice Address - Phone:720-936-9554
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2009-07-11
Last Update Date:2009-07-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CO332B00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes332B00000XSuppliersDurable Medical Equipment & Medical Supplies