Provider Demographics
NPI:1841367232
Name:PROBST AND PROBST CORP
Entity type:Organization
Organization Name:PROBST AND PROBST CORP
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:MR
Authorized Official - First Name:ROBERT
Authorized Official - Middle Name:A
Authorized Official - Last Name:PROBST
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:303-413-0093
Mailing Address - Street 1:2300 CENTRAL AVE
Mailing Address - Street 2:SUITE K
Mailing Address - City:BOULDER
Mailing Address - State:CO
Mailing Address - Zip Code:80301-2861
Mailing Address - Country:US
Mailing Address - Phone:303-413-0093
Mailing Address - Fax:303-413-0094
Practice Address - Street 1:2300 CENTRAL AVE
Practice Address - Street 2:SUITE K
Practice Address - City:BOULDER
Practice Address - State:CO
Practice Address - Zip Code:80301-2861
Practice Address - Country:US
Practice Address - Phone:303-413-0093
Practice Address - Fax:303-413-0094
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-11-29
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CO41-85976-0000332B00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes332B00000XSuppliersDurable Medical Equipment & Medical Supplies