Organization
PHOENIX MEDICAL SUPPLY SPECIALISTS, LLC
Active
Other names
Phoenix Medical Supply
Organization subpart
No
Provider details
NPI number
Authorized official
LEONID REZNIKOV (GENERAL PARTNER)
(720) 436-7613
Entity
Organization
Contact information
Practice address
7950 E MISSISSIPPI AVE STE D, DENVER, CO 80247-2151
(303) 747-7189
(303) 955-2397
Mailing address
7950 E MISSISSIPPI AVE STE D, DENVER, CO 80247-2151
(303) 747-7189
(303) 955-2397
Taxonomy
Speciality
Code
Description
License number
State
332B00000X
Durable Medical Equipment & Medical Supplies
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
20201346609
COLORADO STATE
CO
Enumeration date
05/06/2020
Last updated
07/06/2023
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