Healthcare Provider Details

I. General information

NPI: 1346308954
Provider Name (Legal Business Name): DAY SURGERY OF GRAND JUNCTION LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 12/05/2006
Last Update Date: 08/20/2020
Certification Date: 08/20/2020
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1000 WELLINGTON AVE
GRAND JUNCTION CO
81501-8180
US

IV. Provider business mailing address

3900 E MEXICO AVE STE 102
DENVER CO
80210-3941
US

V. Phone/Fax

Practice location:
  • Phone: 970-245-5989
  • Fax: 970-243-9023
Mailing address:
  • Phone: 303-800-2078
  • Fax: 303-800-2078

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code261QA1903X
TaxonomyAmbulatory Surgical Clinic/Center
License Number0526
License Number StateCO

VIII. Authorized Official

Name: CHRISTIAN ELLISON
Title or Position: CEO
Credential:
Phone: 720-273-7449