Provider Demographics
NPI:1831225481
Name:THERAMEDX, LLC
Entity type:Organization
Organization Name:THERAMEDX, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:MEMBER
Authorized Official - Prefix:
Authorized Official - First Name:CHRISTOPHER
Authorized Official - Middle Name:
Authorized Official - Last Name:ANGELLO
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:866-461-5020
Mailing Address - Street 1:755 NORTH AVE STE B
Mailing Address - Street 2:
Mailing Address - City:GRAND JUNCTION
Mailing Address - State:CO
Mailing Address - Zip Code:81501-3112
Mailing Address - Country:US
Mailing Address - Phone:886-461-5020
Mailing Address - Fax:970-257-1880
Practice Address - Street 1:755 NORTH AVE STE B
Practice Address - Street 2:
Practice Address - City:GRAND JUNCTION
Practice Address - State:CO
Practice Address - Zip Code:81501-3112
Practice Address - Country:US
Practice Address - Phone:886-461-5020
Practice Address - Fax:970-257-1880
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-02-26
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes332B00000XSuppliersDurable Medical Equipment & Medical Supplies
Provider Identifiers
StateIdentifier IDID TypeIssuer
CO5501230001Medicare NSC