# BOOMER MEDICAL SUPPLY

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- **Entity:** Organization
- **Status:** Active
- **Organization subpart:** No

## Provider details

- **NPI number:** 1972937043
- **Authorized official:** TIFFANY D SMITH (MEMBER)
- **Authorized official phone:** (720) 998-9552

## Contact information

- **Practice address:** 17935 E FLORIDA DR, AURORA, CO 80017-5315
- **Practice address phone:** (720) 998-9552
- **Practice address fax:** (720) 282-3215
- **Mailing address:** 5520 E 33RD AVE, DENVER, CO 80207-2028
- **Mailing address phone:** (720) 998-9552
- **Mailing address fax:** (720) 282-3215

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 332BX2000X | Oxygen Equipment & Supplies (DME) | 922564188 | CO | Yes |

## Other

- **Enumeration date:** 08/26/2013
- **Last updated:** 08/26/2013