Organization
NORTHWEST REGIONAL ASC, LLC
Active
Other names
Northwest Regional Ambulatory Surgery Center
Organization subpart
No
Provider details
NPI number
Authorized official
JENETHA D MORAN (OFFICER/AUTHORIZED OFFICIAL)
(972) 763-3893
Entity
Organization
Contact information
Practice address
10170 CHURCH RANCH WAY, STE 110, WESTMINSTER, CO 80021-6058
(303) 328-3400
(303) 328-3401
Mailing address
10170 CHURCH RANCH WAY, STE 110, WESTMINSTER, CO 80021-6058
(303) 328-3400
(303) 328-3401
Taxonomy
Speciality
Code
Description
License number
State
261QA1903X
Ambulatory Surgical Clinic/Center
Primary
16P689
CO
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
72636076
—
CO
01
—
P00228297
RAILROAD MEDICARE
CO
Enumeration date
07/14/2005
Last updated
12/03/2019
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