Organization
GRAND VALLEY SURGICAL CENTER, LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MITCHELL SCHWARZBACH (ADMINISTRATOR)
(970) 298-7822
Entity
Organization
Contact information
Practice address
710 WELLINGTON AVE STE 21, GRAND JUNCTION, CO 81501-6102
(970) 298-7800
(970) 298-7850
Mailing address
710 WELLINGTON AVE STE 21, GRAND JUNCTION, CO 81501-6102
(970) 298-7800
(970) 298-7850
Taxonomy
Speciality
Code
Description
License number
State
261QA1903X
Ambulatory Surgical Clinic/Center
Primary
1611ND
CO
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
1611ND
STATE OF COLORADO DEPT OF PUBLIC HEALTH AND ENVIRONMENT ASC LICENSE
CO
05
—
25273388
—
CO
Enumeration date
07/01/2005
Last updated
09/11/2018
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