Healthcare Provider Details

I. General information

NPI: 1477615284
Provider Name (Legal Business Name): ROCKY MOUNTAIN ENDOSCOPY CENTERS, LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 12/15/2006
Last Update Date: 10/11/2024
Certification Date: 10/11/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

10001 WASHINGTON ST
THORNTON CO
80229-2050
US

IV. Provider business mailing address

10001 WASHINGTON ST
THORNTON CO
80229-2050
US

V. Phone/Fax

Practice location:
  • Phone: 303-205-1090
  • Fax: 303-205-1120
Mailing address:
  • Phone: 303-205-1090
  • Fax: 303-205-1120

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code261QA1903X
TaxonomyAmbulatory Surgical Clinic/Center
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code261QE0800X
TaxonomyEndoscopy Clinic/Center
License Number1604XC
License Number StateCO
# 3
Primary TaxonomyN
Taxonomy Code261QE0800X
TaxonomyEndoscopy Clinic/Center
License Number16R178
License Number StateCO
# 4
Primary TaxonomyN
Taxonomy Code261QE0800X
TaxonomyEndoscopy Clinic/Center
License Number1604F6
License Number StateCO

VIII. Authorized Official

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