Organization Active NPI

Boomer Medical Supply

  • Durable Medical Equipment & Medical Supplies
  • Aurora, CO
National Provider Identifier
1184058281
Registry record updated Aug 26, 2013
On this page

Key facts

NPPES NPI Registry
Primary specialty
Durable Medical Equipment & Medical SuppliesTaxonomy code 332B00000X
Legal business name
BOOMER MEDICAL SUPPLY
Practice address
17935 East Florida Drive
Aurora, CO 80017
Phone
(281) 913-9425
Fax
(720) 282-3215
NPI assigned
Aug 26, 2013
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Aug 26, 2013

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name
Tiffany D Calise
Title
Member
Phone
(281) 913-9425

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Durable Medical Equipment & Medical Supplies 332B00000X CO Primary

Addresses

Primary practice location

17935 East Florida Drive
Aurora, CO 80017

Mailing address

17935 E Florida Dr
Aurora, CO 80017-5315
Phone (281) 913-9425

National Provider Directory

National Provider Directory
Tax ID family
Boomer Medical Supply2 organizations share this tax ID, including this one

Other organizations with this tax ID 1

Organizations that report the same tax identification number in the National Provider Directory.

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1377475200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1377475200000",
    "number": "1184058281",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "17935 E FLORIDA DR",
            "city": "AURORA",
            "state": "CO",
            "postal_code": "800175315",
            "telephone_number": "281-913-9425",
            "fax_number": "720-282-3215"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "17935 EAST FLORIDA DRIVE",
            "city": "AURORA",
            "state": "CO",
            "postal_code": "80017",
            "telephone_number": "281-913-9425",
            "fax_number": "720-282-3215"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "BOOMER MEDICAL SUPPLY",
        "organizational_subpart": "NO",
        "enumeration_date": "2013-08-26",
        "last_updated": "2013-08-26",
        "status": "A",
        "authorized_official_last_name": "CALISE",
        "authorized_official_first_name": "TIFFANY",
        "authorized_official_middle_name": "D",
        "authorized_official_title_or_position": "MEMBER",
        "authorized_official_telephone_number": "281-913-9425"
    },
    "taxonomies": [
        {
            "code": "332B00000X",
            "taxonomy_group": "",
            "desc": "Durable Medical Equipment & Medical Supplies",
            "state": "CO",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Aurora, CO

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 26, 2013; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.