Greg Charles Glendening
Individual provider Active NPI Home Modifications Contractor · Austin, CO
NPI 1558720342 · NPPES record last updated Feb 22, 2016
Key facts
- NPI
- 1558720342
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Home Modifications Contractor 171WH0202X
- Practice address
- 9871 Horseshoe LN
Austin, CO 81410-8223 - Phone
- (970) 835-9603
- Fax
- (970) 835-3182
- NPI assigned
- Feb 22, 2016
- Sex
- Male
- Sole proprietor
- Yes
Medicare participation
- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
- Medicare enrollment (NPD)
- No
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Home Modifications Contractor | 171WH0202X | Yes |
Addresses
Primary practice location
9871 Horseshoe LN
Austin, CO 81410-8223
Mailing address
9871 Horseshoe LN
Austin, CO 81410-8223
Phone (970) 835-9603
Other identifiers
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 31685739 | Medicaid | CO |
Other providers in Austin, CO
All providers in Austin, CO · Home Modifications Contractor in Colorado
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Feb 22, 2016. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.