Organization
STADIUM MEDICAL, INC.
Active
Organization subpart
No
Provider details
NPI number
Authorized official
BERNIE AMES (ADMINISTRATIVE SPECIALIST)
(303) 549-7916
Entity
Organization
Contact information
Practice address
695 CANOSA CT, DENVER, CO 80204-4143
(720) 630-2000
Mailing address
695 CANOSA CT, DENVER, CO 80204-4143
(720) 630-2000
Taxonomy
Speciality
Code
Description
License number
State
341600000X
Ambulance
Primary
—
—
3416L0300X
Land Ambulance
06-7429
CO
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
12959049
—
CO
Enumeration date
06/20/2008
Last updated
06/24/2021
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