Provider Demographics
NPI:1134854748
Name:ALTITUDE ELECTRIC LLC
Entity type:Organization
Organization Name:ALTITUDE ELECTRIC LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:JODY
Authorized Official - Middle Name:
Authorized Official - Last Name:WAGNER
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:303-816-6999
Mailing Address - Street 1:PO BOX 1528
Mailing Address - Street 2:
Mailing Address - City:CONIFER
Mailing Address - State:CO
Mailing Address - Zip Code:80433-1528
Mailing Address - Country:US
Mailing Address - Phone:303-816-6999
Mailing Address - Fax:
Practice Address - Street 1:19336 GODDARD RANCH CT UNIT 100
Practice Address - Street 2:
Practice Address - City:MORRISON
Practice Address - State:CO
Practice Address - Zip Code:80465-9108
Practice Address - Country:US
Practice Address - Phone:303-816-6999
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2022-07-18
Last Update Date:2022-07-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes171WH0202XOther Service ProvidersContractorHome ModificationsGroup - Multi-Specialty