Elshadai Medical Services Inc.

Primary specialty

Durable Medical Equipment & Medical SuppliesTaxonomy code 332B00000X

License

75521768 Issued in CO

Legal business name

ELSHADAI MEDICAL SERVICES INC.

Practice address

2620 S Parker Rd
Suite # 150
Aurora, CO 80014-1608

Phone

(303) 755-5656

NPI assigned

Nov 27, 2006

Organization subpart

No

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

Authorized official

Name

Boma Adelaide Fonguh

Title

Owner

Phone

(303) 755-5656

Specialties & licenses 1

Addresses

Other identifiers 1

Locations

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

{
    "created_epoch": "1164585600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1598054400000",
    "number": "1306912910",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2620 S PARKER RD",
            "address_2": "SUITE # 150",
            "city": "AURORA",
            "state": "CO",
            "postal_code": "800141608",
            "telephone_number": "303-755-5656"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2620 S PARKER RD",
            "address_2": "SUITE # 150",
            "city": "AURORA",
            "state": "CO",
            "postal_code": "800141608",
            "telephone_number": "303-755-5656"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "ELSHADAI MEDICAL SERVICES INC.",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-11-27",
        "last_updated": "2020-08-22",
        "status": "A",
        "authorized_official_last_name": "FONGUH",
        "authorized_official_first_name": "BOMA",
        "authorized_official_middle_name": "ADELAIDE",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "303-755-5656"
    },
    "taxonomies": [
        {
            "code": "332B00000X",
            "taxonomy_group": "",
            "desc": "Durable Medical Equipment & Medical Supplies",
            "state": "CO",
            "license": "75521768",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "75521768",
            "state": "CO"
        }
    ],
    "endpoints": [],
    "other_names": []
}

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• Durable Medical Equipment & Medical Supplies in Aurora, CO
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• Durable Medical Equipment & Medical Supplies in Colorado

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 22, 2020; 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.