Organization Name: | BOOMER MEDICAL SUPPLY |
NPI Number: | 1184058281 |
Entity Type Code: | Organizational (2) |
Authorized Official Name: | TIFFANY D CALISE (MEMBER) |
Mailing Address: | 17935 East Florida Drive Aurora |
State: | CO US |
Postal Code: | 80017 |
Phone Number: | 2819139425 |
Fax Number: | 7202823215 |
NPI Enumeration Date: | 08/26/2013 |
NPI Last Update Date: | 08/26/2013 |
Replacement NPI: | 0 |
NPI Deactivation Date: | |
NPI Reactivation Date: |
Taxonomy Information: | |
Healthcare Provider Taxonomy: | 332B00000X |
License Number: | |
Healthcare Provider Taxonomy: (Secondary) | Y |
State: | CO |
Taxonomy Type: | Suppliers |
Taxonomy Classification: | Durable Medical Equipment & Medical Supplies |
Taxonomy Specialization: | |
Taxonomy Definition: | A supplier of medical equipment such as respirators, wheelchairs, home dialysis systems, or monitoring systems, that are prescribed by a physician for a patient |