Healthcare Provider Details

I. General information

NPI: 1922160357
Provider Name (Legal Business Name): ARAPAHOE ENDOSCOPY CENTER PARTNERSHIP PLLP
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 12/14/2006
Last Update Date: 08/30/2013
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1001 SOUTHPARK DR
LITTLETON CO
80120-5641
US

IV. Provider business mailing address

1001 SOUTHPARK DR
LITTLETON CO
80120-5641
US

V. Phone/Fax

Practice location:
  • Phone: 303-722-8987
  • Fax: 303-722-2935
Mailing address:
  • Phone: 303-722-8987
  • Fax: 303-722-2935

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code261QA1903X
TaxonomyAmbulatory Surgical Clinic/Center
License Number0930
License Number StateCO

VIII. Authorized Official

Name: LANCE GOUDZWAARD
Title or Position: CEO
Credential: CEO
Phone: 303-205-1090