Healthcare Provider Details

I. General information

NPI: 1447799044
Provider Name (Legal Business Name): GREENWOOD ASC, LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 02/15/2017
Last Update Date: 07/23/2021
Certification Date: 07/23/2021
Deactivation Date:
Reactivation Date:

III. Provider practice location address

355 UNION BLVD STE 10
LAKEWOOD CO
80228-1500
US

IV. Provider business mailing address

355 UNION BLVD
LAKEWOOD CO
80228-6516
US

V. Phone/Fax

Practice location:
  • Phone: 972-763-3893
  • Fax: 972-692-6745
Mailing address:
  • Phone: 972-763-3893
  • Fax: 303-689-8700

VI. Provider taxonomy

Scope of Practice (Provider specialty)

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

VIII. Authorized Official

Name: TERESA DANNA
Title or Position: OFFICER / AUTHORIZED OFFICIAL
Credential:
Phone: 972-763-3890