Organization
ENDOSCOPY CENTER OF THE ROCKIES LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DAUS MAHNKE (BOARD MEMBER)
(303) 604-5000
Entity
Organization
Contact information
Practice address
1551 PROFESSIONAL LN STE 295, LONGMONT, CO 80501-6972
(303) 604-5000
Mailing address
382 S ARTHUR AVE, LOUISVILLE, CO 80027-3094
(303) 604-5000
(720) 890-0364
Taxonomy
Speciality
Code
Description
License number
State
261QA1903X
Ambulatory Surgical Clinic/Center
Primary
—
CO
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
490005424
RAILROAD MEDICARE
CO
05
—
95055011
—
CO
01
—
EN64670
BCBS
CO
Enumeration date
10/08/2008
Last updated
10/04/2021
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