Provider Demographics
NPI:1013119080
Name:HYGEIA MEDICAL SUPPLIES AND SERVICES, INC.
Entity Type:Organization
Organization Name:HYGEIA MEDICAL SUPPLIES AND SERVICES, INC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:MR
Authorized Official - First Name:KOUROSH
Authorized Official - Middle Name:
Authorized Official - Last Name:MOTLAGH
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:303-758-9413
Mailing Address - Street 1:12640 W CEDAR DR STE E
Mailing Address - Street 2:
Mailing Address - City:LAKEWOOD
Mailing Address - State:CO
Mailing Address - Zip Code:80228-2032
Mailing Address - Country:US
Mailing Address - Phone:303-758-9413
Mailing Address - Fax:
Practice Address - Street 1:12640 W CEDAR DR STE E
Practice Address - Street 2:
Practice Address - City:LAKEWOOD
Practice Address - State:CO
Practice Address - Zip Code:80228-2032
Practice Address - Country:US
Practice Address - Phone:303-758-9413
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-06-01
Last Update Date:2021-09-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes332B00000XSuppliersDurable Medical Equipment & Medical Supplies
Provider Identifiers
StateIdentifier IDID TypeIssuer
CO82577366Medicaid
CO6011680001Medicare NSC