MEDICARE: BELMAR AMBULATORY SURGICAL CENTER, LLC

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	261QA1903X	Ambulatory Surgical Clinic/Center

General Provider Information

NPI Number	:	1912053570
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	BELMAR AMBULATORY SURGICAL CENTER, LLC

Provider Business Mailing Address
First Line	:	325 S TELLER ST STE 200
Second Line	:
City	:	LAKEWOOD
State	:	CO
Zip	:	80226-7389
Country	:	US
Telephone Number	:	303-934-7000
Fax Number	:	303-934-7006

Provider Business Practice Location Address
First Line	:	325 S TELLER ST STE 200
Second Line	:
City	:	LAKEWOOD
State	:	CO
Zip	:	80226-7389
Country	:	US
Telephone Number	:	303-934-7000
Fax Number	:	303-934-7006

Authorized Official
Title or Position	:	MANAGER
Name	:	KAREN BRANIA
Credential	:
Telephone Number	:	716-799-0712

Provider Enumeration Date	:	01/26/2007
Last Update Date	:	05/17/2024

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