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General NPI Number Information
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NPI Number | 1679134795
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Entity Type | Organization
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Legal Business Name | GREELEY ENDOSCOPY CENTER, LLC
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Dates
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Enumeration Date | 06/28/2019
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Last Update Date | 08/01/2023
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Provider Practice Location Address
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Address Line | 8227 W 20TH ST
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City | GREELEY
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State | CO
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Zip | 80634-3039
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Country | US
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Telephone | 970-420-8863
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Fax |
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Provider Business Mailing Address
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Address Line | 8227 W 20TH ST
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City | GREELEY
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State | CO
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Zip | 80634-3039
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Country | US
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Telephone | 970-573-7555
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Fax | 970-744-5309
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Authorized Official
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Title or Position | ADMINISTRATOR
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Name | KARISSA HALL
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Credential |
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Telephone | 970-573-7555
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 261QA1903X
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Taxonomy Name | Ambulatory Surgical Clinic/Center
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License Number |
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License Number State |
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