Healthcare Provider Details

I. General information

NPI: 1215609359
Provider Name (Legal Business Name): CENTRAL COLORADO ANESTHESIA ASSOCIATES, LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 09/28/2021
Last Update Date: 09/27/2023
Certification Date: 09/27/2023
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1600 PRAIRIE CENTER PKWY
BRIGHTON CO
80601-4006
US

IV. Provider business mailing address

PO BOX 947630
ATLANTA GA
30394-7630
US

V. Phone/Fax

Practice location:
  • Phone: 303-498-1600
  • Fax: 866-665-8561
Mailing address:
  • Phone: 800-242-5080
  • Fax: 727-900-7770

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code367500000X
TaxonomyCertified Registered Nurse Anesthetist
License Number
License Number State

VIII. Authorized Official

Name: JEFF PERRY
Title or Position: MANAGER
Credential:
Phone: 502-418-4700