Provider Demographics
NPI:1770528416
Name:MEDCOM GROUP LIMITED
Entity type:Organization
Organization Name:MEDCOM GROUP LIMITED
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CEO
Authorized Official - Prefix:
Authorized Official - First Name:SALLIE
Authorized Official - Middle Name:
Authorized Official - Last Name:BARNETT
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:970-587-0963
Mailing Address - Street 1:541 E GARDEN DR
Mailing Address - Street 2:UNIT Q
Mailing Address - City:WINDSOR
Mailing Address - State:CO
Mailing Address - Zip Code:80550-3150
Mailing Address - Country:US
Mailing Address - Phone:970-674-3032
Mailing Address - Fax:970-674-3061
Practice Address - Street 1:541 E GARDEN DR
Practice Address - Street 2:UNIT Q
Practice Address - City:WINDSOR
Practice Address - State:CO
Practice Address - Zip Code:80550-3150
Practice Address - Country:US
Practice Address - Phone:970-674-3032
Practice Address - Fax:970-674-3061
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-06-17
Last Update Date:2012-01-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CO19881083526332B00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes332B00000XSuppliersDurable Medical Equipment & Medical Supplies
Provider Identifiers
StateIdentifier IDID TypeIssuer
0349520001Medicare NSC