# NORTHGLENN ENDOSCOPY CENTER LLC

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

## Provider details

- **NPI number:** 1962958223
- **Authorized official:** MR. DAUS MAHNKE MD (BOARD MEMEBER)
- **Authorized official phone:** (303) 604-5000

## Contact information

- **Practice address:** 11900 GRANT STREET, \#320, NORTHGLENN, CO 80233
- **Practice address phone:** (303) 604-5000
- **Practice address fax:** (720) 890-0364
- **Mailing address:** 382 S ARTHUR AVE, LOUISVILLE, CO 80027-3094
- **Mailing address phone:** (303) 604-5000
- **Mailing address fax:** (720) 890-0364

## Taxonomy

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

## Other

- **Enumeration date:** 08/28/2016
- **Last updated:** 03/05/2020

## Other identifiers

| Code | Description | Identifier | Issuer | State |
| --- | --- | --- | --- | --- |
| 05 | — | 9000154492 | — | CO |