Healthcare Provider Details
I. General information
NPI: 1386409019
Provider Name (Legal Business Name): ACCESS SURGICAL CENTER LLC
Entity Type: Organization
Gender:
Sole Proprietor:
II. Dates (important events)
Enumeration Date: 02/21/2024
Last Update Date: 02/21/2024
Certification Date: 02/21/2024
Deactivation Date:
Reactivation Date:
III. Provider practice location address
11 W DRY CREEK CIR STE 120
LITTLETON CO
80120-8078
US
IV. Provider business mailing address
11 W DRY CREEK CIR STE 120
LITTLETON CO
80120-8078
US
V. Phone/Fax
- Phone: 303-951-8100
- Fax: 720-463-1090
- Phone:
- Fax: 720-463-1090
VI. Provider taxonomy
Scope of Practice (Provider specialty)
| # 1 | |
| Primary Taxonomy | Y |
| Taxonomy Code | 261QA1903X |
| Taxonomy | Ambulatory Surgical Clinic/Center |
| License Number | |
| License Number State | |
VIII. Authorized Official
Name:
CORY
LUKER
Title or Position: OWNER
Credential:
Phone: 801-554-6770