Provider Demographics
NPI:1730272733
Name:COLORADO PROFESSIONAL MEDICAL
Entity type:Organization
Organization Name:COLORADO PROFESSIONAL MEDICAL
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:DIRECTOR OF REIMBURSEMENT
Authorized Official - Prefix:
Authorized Official - First Name:SHERYL
Authorized Official - Middle Name:S
Authorized Official - Last Name:PRICE
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:503-493-8288
Mailing Address - Street 1:2005 FRANKLIN ST
Mailing Address - Street 2:SUITE 495
Mailing Address - City:DENVER
Mailing Address - State:CO
Mailing Address - Zip Code:80205-5401
Mailing Address - Country:US
Mailing Address - Phone:303-232-2001
Mailing Address - Fax:303-233-6390
Practice Address - Street 1:2005 FRANKLIN ST STE 495
Practice Address - Street 2:
Practice Address - City:DENVER
Practice Address - State:CO
Practice Address - Zip Code:80205-5401
Practice Address - Country:US
Practice Address - Phone:303-861-4592
Practice Address - Fax:303-861-4338
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:HANGER ORTHOPEDIC GROUP
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2006-10-02
Last Update Date:2008-02-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
335E00000X
CO332B00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes332B00000XSuppliersDurable Medical Equipment & Medical Supplies
No335E00000XSuppliersProsthetic/Orthotic Supplier
Provider Identifiers
StateIdentifier IDID TypeIssuer
CO57472335Medicaid
CO57472335Medicaid