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NPI Code Detail

MEDICARE: COLUMBIA ENDOSCOPY CENTER, LLC

MEDICARE: COLUMBIA ENDOSCOPY CENTER, LLC
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1261QA1903XAmbulatory Surgical Clinic/Center143-1MO

Other Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
1MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number : 1528032711
Entity Type Code : Organization
Provider Name (Legal Business Name) : COLUMBIA ENDOSCOPY CENTER, LLC
Provider Business Mailing Address
First Line : 208 PORTLAND ST
Second Line :
City : COLUMBIA
State : MO
Zip : 65201-6525
Country : US
Telephone Number : 573-449-3500
Fax Number : 573-449-5097
Provider Business Practice Location Address
First Line : 208 PORTLAND ST
Second Line :
City : COLUMBIA
State : MO
Zip : 65201-6525
Country : US
Telephone Number : 573-449-3500
Fax Number : 573-449-5097
Authorized Official
Title or Position : MEDICAL DIRECTOR
Name : DR. NICOLAS LLORENS
Credential : M.D.
Telephone Number : 573-449-3500
Provider Enumeration Date : 02/14/2006
Last Update Date : 06/12/2020

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Directions to “COLUMBIA ENDOSCOPY CENTER, LLC ” Practice Location

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