Provider Demographics
NPI:1265739874
Name:CASA FUTURA TECHNOLOGIES
Entity type:Organization
Organization Name:CASA FUTURA TECHNOLOGIES
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:THOMAS
Authorized Official - Middle Name:DAVID
Authorized Official - Last Name:KEHOE
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:303-417-9752
Mailing Address - Street 1:720 31ST ST
Mailing Address - Street 2:
Mailing Address - City:BOULDER
Mailing Address - State:CO
Mailing Address - Zip Code:80303-2402
Mailing Address - Country:US
Mailing Address - Phone:303-417-9752
Mailing Address - Fax:303-413-0853
Practice Address - Street 1:720 31ST ST
Practice Address - Street 2:
Practice Address - City:BOULDER
Practice Address - State:CO
Practice Address - Zip Code:80303-2402
Practice Address - Country:US
Practice Address - Phone:303-417-9752
Practice Address - Fax:303-413-0853
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2011-02-16
Last Update Date:2011-02-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CO20041107839332B00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes332B00000XSuppliersDurable Medical Equipment & Medical Supplies
Provider Identifiers
StateIdentifier IDID TypeIssuer
CO08003485Medicaid
NJ7307004Medicaid