Healthcare Provider Details

I. General information

NPI: 1275752313
Provider Name (Legal Business Name): PREMIER SURGICAL ASSISTING, INC.
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 04/25/2007
Last Update Date: 08/22/2020
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

7354 ROBB ST
ARVADA CO
80005-3541
US

IV. Provider business mailing address

PO BOX 363
ARVADA CO
80001-0363
US

V. Phone/Fax

Practice location:
  • Phone: 303-403-9080
  • Fax: 303-403-9077
Mailing address:
  • Phone: 303-403-9080
  • Fax: 303-403-9077

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code163WR0006X
TaxonomyRegistered Nurse First Assistant
License Number115549
License Number StateCO

VIII. Authorized Official

Name: MR. ROBERT WILLIAM SUADI
Title or Position: PRESIDENT
Credential: RNFA, CNOR, CFA
Phone: 303-403-9080