1811337926 NPI number — OUTPATIENT SURGICAL RECOVERY SUITES OF COLORADO

Table of content: (NPI 1811337926)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1811337926 NPI number — OUTPATIENT SURGICAL RECOVERY SUITES OF COLORADO

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
OUTPATIENT SURGICAL RECOVERY SUITES OF COLORADO
Provider Last Name:
Provider First Name:
Provider Middle Name:
Provider Name Prefix Text:
Provider Name Suffix Text:
Provider Credential Text:
Provider Gender Code:

Provider's Other Name Information

Provider Other Organization Name:
Provider Other Organization Name Type Code:
Provider Other Last Name:
Provider Other First Name:
Provider Other Middle Name:
Provider Other Name Prefix Text:
Provider Other Name Suffix Text:
Provider Other Credential Text:
Provider Other Last Name Type Code:

NPI Number Information

NPI Number:
1811337926
Entity Type Code:
Organization
Replacement NPI:
Last Update Date:
07/03/2013
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
2779 W HORIZON RIDGE PKWY
Provider Second Line Business Mailing Address:
SUITE 200
Provider Business Mailing Address City Name:
HENDERSON
Provider Business Mailing Address State Name:
NV
Provider Business Mailing Address Postal Code:
89052-4184
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
702-990-2290
Provider Business Mailing Address Fax Number:
702-932-8377

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
9777 S YOSEMITE ST
Provider Second Line Business Practice Location Address:
SUITE 220
Provider Business Practice Location Address City Name:
LONE TREE
Provider Business Practice Location Address State Name:
CO
Provider Business Practice Location Address Postal Code:
80124-3191
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
702-990-2290
Provider Business Practice Location Address Fax Number:
702-932-8377
Provider Enumeration Date:
07/03/2013

Additional Information

Authorized Official

Authorized Official Last Name:
CROVETTI
Authorized Official First Name:
MICHEAL
Authorized Official Middle Name:
JAMES
Authorized Official Title or Position:
OWNER/PRESIDENT
Authorized Official Telephone Number:
702-990-2290

Provider Taxonomy Codes

  • Taxonomy code: 313M00000X ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .

Other Provider's Identifiers (legacy, non-NPI)





Copyright © 2007-2025 www.npivalidator.com