Provider Demographics
NPI:1952335143
Name:BEACON RESPIRATORY SERVICES OF COLORADO, INC.
Entity Type:Organization
Organization Name:BEACON RESPIRATORY SERVICES OF COLORADO, INC.
Other - Org Name:BEACON RESPIRATORY SERVICES OF COLORADO
Other - Org Type:Doing Business As
Authorized Official - Title/Position:DIRECTOR OF PROVIDER SERVICES
Authorized Official - Prefix:
Authorized Official - First Name:ELLYN
Authorized Official - Middle Name:
Authorized Official - Last Name:RILEY
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:407-206-0040
Mailing Address - Street 1:3325 BARTLETT BLVD
Mailing Address - Street 2:
Mailing Address - City:ORLANDO
Mailing Address - State:FL
Mailing Address - Zip Code:32811-6428
Mailing Address - Country:US
Mailing Address - Phone:407-206-0040
Mailing Address - Fax:407-206-0010
Practice Address - Street 1:955 E 58TH AVE UNIT O
Practice Address - Street 2:
Practice Address - City:DENVER
Practice Address - State:CO
Practice Address - Zip Code:80216-1347
Practice Address - Country:US
Practice Address - Phone:303-383-0083
Practice Address - Fax:303-383-0082
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:AEROCARE HOLDINGS, INC
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2006-07-11
Last Update Date:2022-07-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CO40923890000332B00000X
CO332BX2000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes332BX2000XSuppliersDurable Medical Equipment & Medical SuppliesOxygen Equipment & Supplies
No332B00000XSuppliersDurable Medical Equipment & Medical Supplies
Provider Identifiers
StateIdentifier IDID TypeIssuer
4479970001Medicare NSC