Organization
PRESTIGIOUS MEDICAL SUPPLY
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MRS. DOREEN LYONS (PRESIDENT)
(303) 422-1447
Entity
Organization
Contact information
Practice address
7470 W 38TH AVE, WHEAT RIDGE, CO 80033-4845
(303) 422-1447
(303) 422-3019
Mailing address
7480 W. 38TH AVE., WHEATRIDGE, CO 80033-4845
(303) 422-1447
(303) 422-3019
Taxonomy
Speciality
Code
Description
License number
State
332BX2000X
Oxygen Equipment & Supplies (DME)
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
33306338
—
CO
Enumeration date
06/29/2007
Last updated
08/22/2020
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