Organization
NOVAMED SURGERY CENTER OF COLORADO SPRINGS, LLC
Active
Other names
Premier Surgery Center
Organization subpart
No
Provider details
NPI number
Authorized official
JENNIFER B. BALDOCK (OFFICER AND AUTHORIZED OFFICIAL)
(615) 234-5954
Entity
Organization
Contact information
Practice address
3920 N UNION BLVD STE 240, COLORADO SPRINGS, CO 80907-4920
(719) 227-9711
(719) 227-9725
Mailing address
3920 N UNION BLVD STE 240, COLORADO SPRINGS, CO 80907-4920
(719) 227-9711
(847) 296-5990
Taxonomy
Speciality
Code
Description
License number
State
261QA1903X
Ambulatory Surgical Clinic/Center
Primary
0239
CO
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
490005417
RR MEDICARE
—
05
—
75600331
—
CO
Enumeration date
06/20/2005
Last updated
10/12/2023
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