Colorado Lifestyle Medical LLC

Primary specialty

Durable Medical Equipment & Medical SuppliesTaxonomy code 332B00000X

License

42-40450-0000 Issued in CO

Legal business name

COLORADO LIFESTYLE MEDICAL LLC

Practice address

11904 W Cedar Dr
Lakewood, CO 80228-2208

Phone

(303) 988-4875

NPI assigned

Aug 22, 2007

Organization subpart

No

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

Authorized official

Name

Eugene Bernard Aydelott

Title

Co-Owner

Phone

(303) 988-4875

Specialties & licenses 1

Addresses

Locations

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

{
    "created_epoch": "1187740800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1187740800000",
    "number": "1922291079",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "11904 W CEDAR DR",
            "city": "LAKEWOOD",
            "state": "CO",
            "postal_code": "802282208",
            "telephone_number": "303-988-4875"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "11904 W CEDAR DR",
            "city": "LAKEWOOD",
            "state": "CO",
            "postal_code": "802282208",
            "telephone_number": "303-988-4875"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "COLORADO LIFESTYLE MEDICAL LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-08-22",
        "last_updated": "2007-08-22",
        "status": "A",
        "authorized_official_last_name": "AYDELOTT",
        "authorized_official_first_name": "EUGENE",
        "authorized_official_middle_name": "BERNARD",
        "authorized_official_title_or_position": "CO-OWNER",
        "authorized_official_telephone_number": "303-988-4875"
    },
    "taxonomies": [
        {
            "code": "332B00000X",
            "taxonomy_group": "",
            "desc": "Durable Medical Equipment & Medical Supplies",
            "state": "CO",
            "license": "42-40450-0000",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• Durable Medical Equipment & Medical Supplies in Lakewood, CO
• Providers in Lakewood, CO by specialty
• 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, 2007; 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.