Provider Demographics
NPI:1104958800
Name:GRIFFITH MEDICAL
Entity type:Organization
Organization Name:GRIFFITH MEDICAL
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:DRIECTOR
Authorized Official - Prefix:MR
Authorized Official - First Name:MICHAEL
Authorized Official - Middle Name:
Authorized Official - Last Name:GRIFFITH
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:303-378-1604
Mailing Address - Street 1:720 16TH ST
Mailing Address - Street 2:# 504
Mailing Address - City:DENVER
Mailing Address - State:CO
Mailing Address - Zip Code:80202-3243
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:720 16TH ST
Practice Address - Street 2:# 504
Practice Address - City:DENVER
Practice Address - State:CO
Practice Address - Zip Code:80202-3243
Practice Address - Country:US
Practice Address - Phone:303-378-1604
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-03-09
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CO41871500000332BC3200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes332BC3200XSuppliersDurable Medical Equipment & Medical SuppliesCustomized Equipment
Provider Identifiers
StateIdentifier IDID TypeIssuer
CO85558877Medicaid