Provider Demographics
NPI:1669615027
Name:EPIC, LTD
Entity type:Organization
Organization Name:EPIC, LTD
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:MR
Authorized Official - First Name:DAMON
Authorized Official - Middle Name:
Authorized Official - Last Name:OLIVER
Authorized Official - Suffix:
Authorized Official - Credentials:MSPT
Authorized Official - Phone:970-309-4604
Mailing Address - Street 1:PO BOX 10916
Mailing Address - Street 2:
Mailing Address - City:ASPEN
Mailing Address - State:CO
Mailing Address - Zip Code:81612-7353
Mailing Address - Country:US
Mailing Address - Phone:970-309-4604
Mailing Address - Fax:
Practice Address - Street 1:616 E HYMAN AVE
Practice Address - Street 2:C/O ASPEN SPORTS MEDICINE
Practice Address - City:ASPEN
Practice Address - State:CO
Practice Address - Zip Code:81611-2391
Practice Address - Country:US
Practice Address - Phone:970-309-4604
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2009-04-15
Last Update Date:2009-04-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes332BC3200XSuppliersDurable Medical Equipment & Medical SuppliesCustomized Equipment