Provider Demographics
NPI:1013666585
Name:WILLIAMS & TAYLOR DME SUPPLIES LLC
Entity Type:Organization
Organization Name:WILLIAMS & TAYLOR DME SUPPLIES LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:CRYSTAL
Authorized Official - Middle Name:
Authorized Official - Last Name:WILLIAMS S
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:303-715-8853
Mailing Address - Street 1:8300 E PRENTICE AVE APT 305
Mailing Address - Street 2:
Mailing Address - City:GREENWOOD VILLAGE
Mailing Address - State:CO
Mailing Address - Zip Code:80111-2778
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:9251 E PEAKVIEW AVE
Practice Address - Street 2:
Practice Address - City:GREENWOOD VILLAGE
Practice Address - State:CO
Practice Address - Zip Code:80111-5307
Practice Address - Country:US
Practice Address - Phone:303-715-8853
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2022-03-22
Last Update Date:2022-03-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes332B00000XSuppliersDurable Medical Equipment & Medical Supplies
Provider Identifiers
StateIdentifier IDID TypeIssuer
PENDINGOtherPENDING
COPENDINGMedicaid