Organization
PARKWEST SURGERY CENTER, LLC.
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MR. MICHAEL T. BAXTER (OPERATIONS MANAGER)
(719) 253-7032
Entity
Organization
Contact information
Practice address
3676 PARKER BLVD, SUITE 140, PUEBLO, CO 81008-2212
(719) 253-7032
(719) 253-7090
Mailing address
PO BOX 17874, DENVER, CO 80217-0874
(719) 253-7032
(719) 253-7090
Taxonomy
Speciality
Code
Description
License number
State
261QA1903X
Ambulatory Surgical Clinic/Center
Primary
0150
CO
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
79103731
—
CO
Enumeration date
12/22/2006
Last updated
02/04/2008
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