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Organization
ENDOSCOPY CENTER OF THE ROCKIES LLC
Active
Organization
ENDOSCOPY CENTER OF THE ROCKIES LLC
Active
Other names
Endoscopy Center of the Rockies Boulder
Organization subpart
No
Provider details
NPI number
Authorized official
DR. DAUS MAHNKE MD (BOARD MEMBER)
(303) 604-5000
Entity
Organization
Contact information
Practice address
1755 48TH ST, SUITE 100, BOULDER, CO 80301-2711
(303) 604-5000
(720) 890-0364
Mailing address
382 S ARTHUR AVE, LOUISVILLE, CO 80027-3094
(303) 604-5000
(720) 890-0364
Taxonomy
Speciality
Code
Description
License number
State
261QA1903X
Ambulatory Surgical Clinic/Center
Primary
1064
CO
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
490005424
RAILROAD MEDICARE
CO
05
—
95055011
—
CO
01
—
EN64670
BCBS
CO
Enumeration date
07/22/2008
Last updated
03/05/2020
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