Healthcare Provider Details

I. General information

NPI: 1275682627
Provider Name (Legal Business Name): SUMMIT VIEW SURGERY CENTER, LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 01/08/2007
Last Update Date: 09/06/2024
Certification Date: 09/06/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

7730 S BROADWAY
LITTLETON CO
80122
US

IV. Provider business mailing address

7730 S BROADWAY
LITTLETON CO
80122-2602
US

V. Phone/Fax

Practice location:
  • Phone: 303-730-2376
  • Fax: 303-730-2376
Mailing address:
  • Phone: 303-730-2376
  • Fax: 303-730-8147

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code261QA1903X
TaxonomyAmbulatory Surgical Clinic/Center
License Number16N603
License Number StateCO

VIII. Authorized Official

Name: CHRISTOPHER HARTSHORN
Title or Position: AUTHORIZED OFFICIAL
Credential:
Phone: 314-800-2017