Provider Demographics
NPI:1164600714
Name:ADVANCED SURGICAL SUPPORT
Entity Type:Organization
Organization Name:ADVANCED SURGICAL SUPPORT
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:MR
Authorized Official - First Name:RALPH
Authorized Official - Middle Name:
Authorized Official - Last Name:WINKLER
Authorized Official - Suffix:JR
Authorized Official - Credentials:
Authorized Official - Phone:303-814-1339
Mailing Address - Street 1:4833 FRONT ST
Mailing Address - Street 2:B299
Mailing Address - City:CASTLE ROCK
Mailing Address - State:CO
Mailing Address - Zip Code:80104-7902
Mailing Address - Country:US
Mailing Address - Phone:303-814-1339
Mailing Address - Fax:303-663-6518
Practice Address - Street 1:4833 FRONT ST
Practice Address - Street 2:B299
Practice Address - City:CASTLE ROCK
Practice Address - State:CO
Practice Address - Zip Code:80104-7902
Practice Address - Country:US
Practice Address - Phone:303-814-1339
Practice Address - Fax:303-663-6518
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2008-02-06
Last Update Date:2008-02-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes174400000XOther Service ProvidersSpecialistGroup - Multi-Specialty