Organization
OBSIDIAN MEDICAL LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
KAREY M JIRON R.T. (R) (OWNER)
(970) 201-3721
Entity
Organization
Contact information
Practice address
3096 I-70 BUSINESS LOOP UNIT E, GRAND JUNCTION, CO 81504-4419
(970) 201-3721
Mailing address
2887 JEAN LN, GRAND JUNCTION, CO 81506-4826
(970) 201-3721
Taxonomy
Speciality
Code
Description
License number
State
332B00000X
Durable Medical Equipment & Medical Supplies
Primary
—
—
332BC3200X
Customized Equipment (DME)
—
—
332BD1200X
Dialysis Equipment & Supplies (DME)
—
—
332BN1400X
Nursing Facility Supplies (DME)
—
—
332BP3500X
Parenteral & Enteral Nutrition Supplies (DME)
—
—
Other
Enumeration date
07/31/2024
Last updated
07/31/2024
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