Provider Demographics
NPI:1104172279
Name:SUREPOINT MEDICAL LLC
Entity type:Organization
Organization Name:SUREPOINT MEDICAL LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CHIEF OPERATIONS OFFICER
Authorized Official - Prefix:MR
Authorized Official - First Name:GREGORY
Authorized Official - Middle Name:
Authorized Official - Last Name:SCHRECK
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:866-351-2636
Mailing Address - Street 1:373 INVERNESS PKWY STE 206
Mailing Address - Street 2:
Mailing Address - City:ENGLEWOOD
Mailing Address - State:CO
Mailing Address - Zip Code:80112-5898
Mailing Address - Country:US
Mailing Address - Phone:866-351-2636
Mailing Address - Fax:866-367-7936
Practice Address - Street 1:373 INVERNESS PKWY STE 206
Practice Address - Street 2:
Practice Address - City:ENGLEWOOD
Practice Address - State:CO
Practice Address - Zip Code:80112-5898
Practice Address - Country:US
Practice Address - Phone:866-351-2636
Practice Address - Fax:866-367-7936
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2012-07-26
Last Update Date:2013-01-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CO5912332B00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes332B00000XSuppliersDurable Medical Equipment & Medical Supplies
Provider Identifiers
StateIdentifier IDID TypeIssuer
KS5650510001Medicare NSC