Provider Demographics
NPI:1669518171
Name:COLORADO MEDICAL, INC.
Entity type:Organization
Organization Name:COLORADO MEDICAL, INC.
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:MR
Authorized Official - First Name:CHRISTOPHER
Authorized Official - Middle Name:SMITH
Authorized Official - Last Name:NOLAN
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:720-322-0101
Mailing Address - Street 1:250 E DRY CREEK RD STE 114
Mailing Address - Street 2:
Mailing Address - City:LITTLETON
Mailing Address - State:CO
Mailing Address - Zip Code:80122-2625
Mailing Address - Country:US
Mailing Address - Phone:720-322-0101
Mailing Address - Fax:720-322-0111
Practice Address - Street 1:250 E DRY CREEK RD STE 114
Practice Address - Street 2:
Practice Address - City:LITTLETON
Practice Address - State:CO
Practice Address - Zip Code:80122-2625
Practice Address - Country:US
Practice Address - Phone:720-322-0101
Practice Address - Fax:720-322-0111
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-01-30
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes332B00000XSuppliersDurable Medical Equipment & Medical Supplies
Provider Identifiers
StateIdentifier IDID TypeIssuer
CO5689900001Medicare ID - Type Unspecified