Provider Demographics
NPI:1669797262
Name:COLORADO HAND THERAPY, LLC
Entity type:Organization
Organization Name:COLORADO HAND THERAPY, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:GENERAL MANAGER
Authorized Official - Prefix:
Authorized Official - First Name:KARL
Authorized Official - Middle Name:R
Authorized Official - Last Name:ZANDER
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:303-777-0424
Mailing Address - Street 1:P.O. BOX 646
Mailing Address - Street 2:
Mailing Address - City:CONIFER
Mailing Address - State:CO
Mailing Address - Zip Code:80433
Mailing Address - Country:US
Mailing Address - Phone:303-777-0424
Mailing Address - Fax:303-674-1993
Practice Address - Street 1:3045 WHITMAN DR
Practice Address - Street 2:SUITE 105
Practice Address - City:EVERGREEN
Practice Address - State:CO
Practice Address - Zip Code:80439-2210
Practice Address - Country:US
Practice Address - Phone:303-777-0424
Practice Address - Fax:303-674-1993
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2010-04-07
Last Update Date:2012-10-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CO15162580000332B00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes332B00000XSuppliersDurable Medical Equipment & Medical Supplies
Provider Identifiers
StateIdentifier IDID TypeIssuer
CO73422746Medicaid
COCOB5009Medicare PIN
CO6362470002Medicare NSC