Provider Demographics
NPI:1972737773
Name:CASTLE PINES MEDICAL, INC.
Entity Type:Organization
Organization Name:CASTLE PINES MEDICAL, INC.
Other - Org Name:DAYSPRING MEDIAL PRODUCTS
Other - Org Type:Doing Business As
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:MR
Authorized Official - First Name:RODNEY
Authorized Official - Middle Name:
Authorized Official - Last Name:NUSS
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:303-442-4514
Mailing Address - Street 1:14883 E HINSDALE AVE
Mailing Address - Street 2:SUITE 2
Mailing Address - City:CENTENNIAL
Mailing Address - State:CO
Mailing Address - Zip Code:80112-6909
Mailing Address - Country:US
Mailing Address - Phone:303-442-4514
Mailing Address - Fax:303-530-2610
Practice Address - Street 1:14883 E HINSDALE AVE
Practice Address - Street 2:SUITE 2
Practice Address - City:CENTENNIAL
Practice Address - State:CO
Practice Address - Zip Code:80112-6909
Practice Address - Country:US
Practice Address - Phone:303-442-4514
Practice Address - Fax:303-530-2610
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2009-05-07
Last Update Date:2009-05-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CO35-11991-0000332BP3500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes332BP3500XSuppliersDurable Medical Equipment & Medical SuppliesParenteral & Enteral Nutrition