Organization
SURGERY CENTER OF FORT COLLINS LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
JUDY SANSOM (BUSINESS OFFICE MANAGER)
(970) 494-4827
Entity
Organization
Contact information
Practice address
1100 E PROSPECT RD, FORT COLLINS, CO 80525-5304
(970) 494-4800
Mailing address
1100 E PROSPECT RD, FORT COLLINS, CO 80525-5304
Taxonomy
Speciality
Code
Description
License number
State
261QA1903X
Ambulatory Surgical Clinic/Center
Primary
1271
CO
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
95038337
—
CO
Enumeration date
11/29/2006
Last updated
11/07/2013
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