Healthcare Provider Details

I. General information

NPI: 1396103420
Provider Name (Legal Business Name): ASC DENVER WEST LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 02/03/2016
Last Update Date: 02/09/2016
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

13402 W COAL MINE AVE SUITE 300
LITTLETON CO
80127-5407
US

IV. Provider business mailing address

201 FILLMORE ST SUITE 201
DENVER CO
80206-5022
US

V. Phone/Fax

Practice location:
  • Phone: 303-578-0937
  • Fax: 720-302-1755
Mailing address:
  • Phone: 303-578-0937
  • Fax: 720-302-1755

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: TAMMY ROBERTS
Title or Position: CLINICAL DIRECTOR
Credential: RN, BSN, CASC
Phone: 303-578-0937