# COAL CREEK AMBULATORY SURGERY CENTER PC

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- **Entity:** Organization
- **Status:** Active
- **Other names:** Coal Creek Ambulatory Surgery Center
- **Organization subpart:** No

## Provider details

- **NPI number:** 1417294745
- **Authorized official:** BECKY BUCKLEY (BILLING MANAGER)
- **Authorized official phone:** (970) 522-2750

## Contact information

- **Practice address:** 130 OLD LARAMIE TRL BLDG 4, LAFAYETTE, CO 80026
- **Practice address phone:** (303) 664-9400
- **Mailing address:** PO BOX 767, LAFAYETTE, CO 80026
- **Mailing address phone:** (303) 664-9400

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 261QA1903X | Ambulatory Surgical Clinic/Center | CO44716 | CO | Yes |

## Other

- **Enumeration date:** 01/07/2013
- **Last updated:** 11/27/2023

## Other identifiers

| Code | Description | Identifier | Issuer | State |
| --- | --- | --- | --- | --- |
| 05 | — | 9000150725 | — | CO |