Organization
LANX PUERTO RICO, LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MR. RANDAL SCOTT FESMIRE (COMPLIANCE OFFICER)
(303) 501-8534
Entity
Organization
Contact information
Practice address
6 CALLE MARIANO RAMIREZ BAGES APT 11F, SAN JUAN, PR 00907-1686
(303) 443-7500
Mailing address
310 INTERLOCKEN PKWY, SUITE 120, BROOMFIELD, CO 80021-3479
(303) 443-7500
Taxonomy
Speciality
Code
Description
License number
State
332B00000X
Durable Medical Equipment & Medical Supplies
Primary
—
—
Other
Enumeration date
06/06/2013
Last updated
06/28/2018
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