Organization
ANIMAS SURGICAL HOSPITAL, LLC
Active
Parent organization
ANIMAS SURGICAL HOSPITAL, LLC
Other names
Animas Family Medicine
Organization subpart
Yes
Provider details
NPI number
Legal business name
ANIMAS SURGICAL HOSPITAL, LLC
Authorized official
JENNIFER BOYD BALDOCK (OFFICER AND AUTHORIZED OFFICIAL)
(615) 234-5954
Entity
Organization
Contact information
Practice address
575 RIVERGATE LANE, #105, DURANGO, CO 81301
(970) 385-2344
(405) 841-9354
Mailing address
6128 S LYNCREST AVE, SIOUX FALLS, SD 57108-2560
(888) 955-0501
(605) 274-6186
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
0109
CO
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
34172271
—
CO
Enumeration date
12/20/2007
Last updated
02/08/2023
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