Provider Demographics
NPI:1073626305
Name:SURGICAL CONCEPTS, LLC
Entity Type:Organization
Organization Name:SURGICAL CONCEPTS, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CEO
Authorized Official - Prefix:
Authorized Official - First Name:HIEDI
Authorized Official - Middle Name:
Authorized Official - Last Name:FREY
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:720-214-2549
Mailing Address - Street 1:777 E GIRARD AVE STE 250
Mailing Address - Street 2:
Mailing Address - City:ENGLEWOOD
Mailing Address - State:CO
Mailing Address - Zip Code:80113-2784
Mailing Address - Country:US
Mailing Address - Phone:720-214-2549
Mailing Address - Fax:330-744-7876
Practice Address - Street 1:777 E GIRARD AVE STE 250
Practice Address - Street 2:
Practice Address - City:ENGLEWOOD
Practice Address - State:CO
Practice Address - Zip Code:80113-2784
Practice Address - Country:US
Practice Address - Phone:720-214-2549
Practice Address - Fax:330-744-7876
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-08-17
Last Update Date:2008-10-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes246ZE0600XTechnologists, Technicians & Other Technical Service ProvidersSpecialist/Technologist, OtherElectroneurodiagnosticGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
COC553418Medicare ID - Type Unspecified