Provider Demographics
NPI:1063061570
Name:MSI ENTERPRISES LLC
Entity type:Organization
Organization Name:MSI ENTERPRISES LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:ADMINISTRATOR (BACK UP)
Authorized Official - Prefix:DR
Authorized Official - First Name:EHIABHI
Authorized Official - Middle Name:KINGSLEY
Authorized Official - Last Name:EHIZUELEN
Authorized Official - Suffix:
Authorized Official - Credentials:PHARM D
Authorized Official - Phone:720-609-5106
Mailing Address - Street 1:2323 S TROY ST STE 5-120
Mailing Address - Street 2:
Mailing Address - City:AURORA
Mailing Address - State:CO
Mailing Address - Zip Code:80014-1958
Mailing Address - Country:US
Mailing Address - Phone:720-609-5106
Mailing Address - Fax:720-505-8187
Practice Address - Street 1:2323 S TROY ST STE 5-120
Practice Address - Street 2:
Practice Address - City:AURORA
Practice Address - State:CO
Practice Address - Zip Code:80014-1958
Practice Address - Country:US
Practice Address - Phone:720-609-5106
Practice Address - Fax:720-505-8187
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2019-09-06
Last Update Date:2019-09-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251E00000XAgenciesHome Health
Provider Identifiers
StateIdentifier IDID TypeIssuer
CO04N219OtherSTATE LICENSE NUMBER