Organization
SOURCE 1
Active
Other names
Source 1 - DME
Organization subpart
No
Provider details
NPI number
Authorized official
MR. TRACY JOHN FOX (BUSINESS OWNER)
(303) 952-0396
Entity
Organization
Contact information
Practice address
1615 FOXTRAIL DR STE 190, LOVELAND, CO 80538-9087
(303) 952-0396
(303) 595-5262
Mailing address
3012 MICA CT, SUPERIOR, CO 80027-4548
(303) 952-0396
(303) 595-5262
Taxonomy
Speciality
Code
Description
License number
State
332BC3200X
Customized Equipment (DME)
Primary
4274647
CO
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
38059525
—
CO
Enumeration date
11/09/2009
Last updated
11/09/2009
About Stedi
Stedi is the only programmable healthcare clearinghouse. You can use Stedi's APIs to process eligibility checks, claims, remits, and more.
Contact us