# COLTON CA MULTI ASC LP

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- **Entity:** Organization
- **Status:** Active
- **Other names:** Premier Outpatient Surgery Center
- **Organization subpart:** No

## Provider details

- **NPI number:** 1629313739
- **Authorized official:** MR. JEFFERY SNODGRASS (PRESIDENT)
- **Authorized official phone:** (615) 665-1283

## Contact information

- **Practice address:** 1003 E BRIER DRIVE, SUITE 170, SAN BERNARDINO, CA 92408-2862
- **Practice address phone:** (909) 370-2190
- **Practice address fax:** (909) 370-2266
- **Mailing address:** 1A BURTON HILLS BLVD., LICENSURE AND CERT DEPT, NASHVILLE, TN 37215-6187
- **Mailing address phone:** (615) 263-4011
- **Mailing address fax:** (615) 234-1720

## Taxonomy

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

## Other

- **Enumeration date:** 11/29/2012
- **Last updated:** 01/20/2023