Provider Demographics
NPI:1184745101
Name:TREVAS INC
Entity type:Organization
Organization Name:TREVAS INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT OWNER
Authorized Official - Prefix:
Authorized Official - First Name:TREVA
Authorized Official - Middle Name:M
Authorized Official - Last Name:STUTZMAN
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:303-691-9991
Mailing Address - Street 1:6460 E YALE AVE
Mailing Address - Street 2:STE G20B
Mailing Address - City:DENVER
Mailing Address - State:CO
Mailing Address - Zip Code:80222
Mailing Address - Country:US
Mailing Address - Phone:303-691-9991
Mailing Address - Fax:303-691-9904
Practice Address - Street 1:6460 E YALE AVE
Practice Address - Street 2:STE G20B
Practice Address - City:DENVER
Practice Address - State:CO
Practice Address - Zip Code:80222
Practice Address - Country:US
Practice Address - Phone:303-691-9991
Practice Address - Fax:303-691-9904
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-04-03
Last Update Date:2012-09-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CO1189608332B00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes332B00000XSuppliersDurable Medical Equipment & Medical Supplies
Provider Identifiers
StateIdentifier IDID TypeIssuer
CO0390970001Medicare NSC