# ST. VRAIN ENDOSCOPY CENTER LLC

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

## Provider details

- **NPI number:** 1801822341
- **Authorized official:** DR. PETER S. KAYE M.D., F.A.C.G. (MANAGING PARTNER)
- **Authorized official phone:** (720) 932-7713

## Contact information

- **Practice address:** 1551 PROFESSIONAL LN, SUITE 295, LONGMONT, CO 80501-6972
- **Practice address phone:** (303) 702-5900
- **Practice address fax:** (720) 890-0502
- **Mailing address:** 382 S ARTHUR AVE, LOUISVILLE, CO 80027-3094
- **Mailing address phone:** (720) 932-7713
- **Mailing address fax:** (720) 890-0502

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 261QA1903X | Ambulatory Surgical Clinic/Center | 162 | CO | Yes |

## Other

- **Enumeration date:** 06/25/2006
- **Last updated:** 05/16/2008

## Other identifiers

| Code | Description | Identifier | Issuer | State |
| --- | --- | --- | --- | --- |
| 05 | — | 08677344 | — | CO |
| 01 | — | P00128204 | RAILROAD MEDICARE | CO |
| 01 | — | ST66577 | BCBS | CO |