Provider Demographics
NPI:1265991681
Name:OSTOMY, INCORPORATED
Entity type:Organization
Organization Name:OSTOMY, INCORPORATED
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:JULIE
Authorized Official - Middle Name:EBEL
Authorized Official - Last Name:GAREAU
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:954-975-8004
Mailing Address - Street 1:5314 MONTEBELLO LN
Mailing Address - Street 2:
Mailing Address - City:COLORADO SPRINGS
Mailing Address - State:CO
Mailing Address - Zip Code:80918-1956
Mailing Address - Country:US
Mailing Address - Phone:719-985-7205
Mailing Address - Fax:719-344-5182
Practice Address - Street 1:5314 MONTEBELLO LN
Practice Address - Street 2:
Practice Address - City:COLORADO SPRINGS
Practice Address - State:CO
Practice Address - Zip Code:80918-1956
Practice Address - Country:US
Practice Address - Phone:719-985-7205
Practice Address - Fax:719-344-5182
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:OSTOMY, INC.
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2019-03-15
Last Update Date:2019-03-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes332B00000XSuppliersDurable Medical Equipment & Medical Supplies