Provider Demographics
NPI:1912907619
Name:MOUNTAIN VIEW MEDICAL SUPPLY, INC.
Entity Type:Organization
Organization Name:MOUNTAIN VIEW MEDICAL SUPPLY, INC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:VICE PRESIDENT
Authorized Official - Prefix:MRS
Authorized Official - First Name:LYNETTE
Authorized Official - Middle Name:M
Authorized Official - Last Name:HARTLEY
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:303-455-1300
Mailing Address - Street 1:5076 W 58TH AVE
Mailing Address - Street 2:
Mailing Address - City:ARVADA
Mailing Address - State:CO
Mailing Address - Zip Code:80002-7002
Mailing Address - Country:US
Mailing Address - Phone:303-455-1300
Mailing Address - Fax:303-455-1333
Practice Address - Street 1:5076 W 58TH AVE
Practice Address - Street 2:
Practice Address - City:ARVADA
Practice Address - State:CO
Practice Address - Zip Code:80002-7002
Practice Address - Country:US
Practice Address - Phone:303-455-1300
Practice Address - Fax:303-455-1333
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2005-07-26
Last Update Date:2013-04-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CO26-07050-0000332B00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes332B00000XSuppliersDurable Medical Equipment & Medical Supplies