Provider Demographics
NPI:1396103420
Name:ASC DENVER WEST LLC
Entity type:Organization
Organization Name:ASC DENVER WEST LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CLINICAL DIRECTOR
Authorized Official - Prefix:
Authorized Official - First Name:TAMMY
Authorized Official - Middle Name:
Authorized Official - Last Name:ROBERTS
Authorized Official - Suffix:
Authorized Official - Credentials:RN, BSN, CASC
Authorized Official - Phone:303-578-0937
Mailing Address - Street 1:201 FILLMORE ST
Mailing Address - Street 2:SUITE 201
Mailing Address - City:DENVER
Mailing Address - State:CO
Mailing Address - Zip Code:80206-5022
Mailing Address - Country:US
Mailing Address - Phone:303-578-0937
Mailing Address - Fax:720-302-1755
Practice Address - Street 1:13402 W COAL MINE AVE
Practice Address - Street 2:SUITE 300
Practice Address - City:LITTLETON
Practice Address - State:CO
Practice Address - Zip Code:80127-5407
Practice Address - Country:US
Practice Address - Phone:303-578-0937
Practice Address - Fax:720-302-1755
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2016-02-03
Last Update Date:2016-02-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QA1903XAmbulatory Health Care FacilitiesClinic/CenterAmbulatory Surgical