Healthcare Provider Details

I. General information

NPI: 1275786154
Provider Name (Legal Business Name): METRO SURGICAL SERVICES LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 10/23/2008
Last Update Date: 10/23/2008
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

23061 E ALAMO PL
AURORA CO
80015-6673
US

IV. Provider business mailing address

23061 E ALAMO PL
AURORA CO
80015-6673
US

V. Phone/Fax

Practice location:
  • Phone: 303-484-1580
  • Fax:
Mailing address:
  • Phone: 303-484-1580
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code246ZC0007X
TaxonomySurgical Assistant
License Number108079
License Number StateCO

VIII. Authorized Official

Name: AMY E FANNING
Title or Position: CFA/OWNER
Credential: CFA
Phone: 303-484-1580