Healthcare Provider Details

I. General information

NPI: 1780700773
Provider Name (Legal Business Name): SURGICAL ASSISTING SERVICES
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 03/21/2007
Last Update Date: 08/22/2020
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

181 W MEADOW DR
VAIL CO
81657-5242
US

IV. Provider business mailing address

PO BOX 959
EDWARDS CO
81632-0959
US

V. Phone/Fax

Practice location:
  • Phone: 970-376-4153
  • Fax:
Mailing address:
  • Phone: 979-376-4153
  • Fax: 970-926-5764

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code282NR1301X
TaxonomyRural Acute Care Hospital
License Number106668
License Number StateCO

VIII. Authorized Official

Name: ROSE STRATTON CORENMAN
Title or Position: REGISTERED NURSE
Credential: CRNFA
Phone: 979-376-4153