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General NPI Number Information
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NPI Number | 1801899794
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Entity Type | Organization
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Legal Business Name | THE SURGERY CENTER AT PRINTERS PARK, LLC
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Dates
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Enumeration Date | 05/24/2005
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Last Update Date | 11/28/2007
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Provider Practice Location Address
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Address Line | 175 S UNION BLVD STE 100
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City | COLORADO SPRINGS
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State | CO
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Zip | 80910-3117
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Country | US
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Telephone | 719-667-5800
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Fax | 719-667-2854
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Provider Business Mailing Address
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Address Line | 175 S UNION BLVD STE 100
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City | COLORADO SPRINGS
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State | CO
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Zip | 80910-3117
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Country | US
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Telephone | 719-667-5800
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Fax | 719-667-2854
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Authorized Official
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Title or Position | ADMINISTRATOR
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Name | BETH HAMSTRA
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Credential | RN
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Telephone | 719-667-5792
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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 | 0452
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License Number State | CO
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