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Organization
ST. VRAIN ENDOSCOPY CENTER LLC
Active
Organization
ST. VRAIN ENDOSCOPY CENTER LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. PETER S. KAYE M.D., F.A.C.G. (MANAGING PARTNER)
(720) 932-7713
Entity
Organization
Contact information
Practice address
1551 PROFESSIONAL LN, SUITE 295, LONGMONT, CO 80501-6972
(303) 702-5900
(720) 890-0502
Mailing address
382 S ARTHUR AVE, LOUISVILLE, CO 80027-3094
(720) 932-7713
(720) 890-0502
Taxonomy
Speciality
Code
Description
License number
State
261QA1903X
Ambulatory Surgical Clinic/Center
Primary
162
CO
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
08677344
—
CO
01
—
P00128204
RAILROAD MEDICARE
CO
01
—
ST66577
BCBS
CO
Enumeration date
06/25/2006
Last updated
05/16/2008
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