Provider Demographics
NPI:1275708919
Name:WOMEN'S SURGICAL CENTER AT NORTHCARE, LLC
Entity type:Organization
Organization Name:WOMEN'S SURGICAL CENTER AT NORTHCARE, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:ADMINISTRATOR
Authorized Official - Prefix:
Authorized Official - First Name:BRENT
Authorized Official - Middle Name:
Authorized Official - Last Name:ASHBY
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:719-867-7500
Mailing Address - Street 1:5390 N ACADEMY BLVD STE 300
Mailing Address - Street 2:
Mailing Address - City:COLORADO SPRINGS
Mailing Address - State:CO
Mailing Address - Zip Code:80918-4065
Mailing Address - Country:US
Mailing Address - Phone:719-596-6110
Mailing Address - Fax:719-597-6112
Practice Address - Street 1:6071 E WOODMEN RD
Practice Address - Street 2:STE 425
Practice Address - City:COLORADO SPRINGS
Practice Address - State:CO
Practice Address - Zip Code:80923
Practice Address - Country:US
Practice Address - Phone:719-867-7500
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2008-04-24
Last Update Date:2008-04-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QA1903XAmbulatory Health Care FacilitiesClinic/CenterAmbulatory Surgical