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General NPI Number Information
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NPI Number | 1740862606
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Entity Type | Organization
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Legal Business Name | OCR FORT COLLINS ASC & CCC, LLC
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Dates
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Enumeration Date | 04/21/2021
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Last Update Date | 11/12/2024
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Provider Practice Location Address
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Address Line | 2500 E PROSPECT RD
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City | FORT COLLINS
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State | CO
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Zip | 80525-9718
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Country | US
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Telephone | 970-493-4010
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Fax | 970-419-7151
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Provider Business Mailing Address
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Address Line | 2500 E PROSPECT RD
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City | FORT COLLINS
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State | CO
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Zip | 80525-9718
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Country | US
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Telephone | 970-493-4010
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Fax | 970-419-7151
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Authorized Official
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Title or Position | DIRECTOR OF REVENUE CYCLE
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Name | JACOB TRAMP-JOHNSON
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Credential |
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Telephone | 970-419-7041
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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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