# MOUNTAIN VISTA ORTHOPAEDIC SURGERY CENTER, LLC

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- **Entity:** Organization
- **Status:** Active
- **Organization subpart:** No

## Provider details

- **NPI number:** 1336268754
- **Authorized official:** TODD WERNER (DIVISION PRESIDENT)
- **Authorized official phone:** (602) 747-4000

## Contact information

- **Practice address:** 5890 W 13TH ST STE 102, GREELEY, CO 80634-4821
- **Practice address phone:** (970) 922-3844
- **Practice address fax:** (970) 703-9039
- **Mailing address:** 2901 N CENTRAL AVE STE 160, PHOENIX, AZ 85012-2702
- **Mailing address phone:** (602) 747-4000

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 261QA1903X | Ambulatory Surgical Clinic/Center | 0214 | CO | Yes |

## Other

- **Enumeration date:** 03/28/2007
- **Last updated:** 04/16/2026

## Other identifiers

| Code | Description | Identifier | Issuer | State |
| --- | --- | --- | --- | --- |
| 01 | — | 607473700 | DEPT OF LABOR | CO |
| 05 | — | 79826776 | — | CO |