Provider Demographics
NPI:1588801377
Name:CHILDREN'S NORTH SURGERY CENTER, LLC
Entity Type:Organization
Organization Name:CHILDREN'S NORTH SURGERY CENTER, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:VP, CHIEF COMPLIANCE OFFICER
Authorized Official - Prefix:MS
Authorized Official - First Name:LINDA
Authorized Official - Middle Name:
Authorized Official - Last Name:MICHAEL
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:720-777-6537
Mailing Address - Street 1:469 STATE HIGHWAY 7 STE 2
Mailing Address - Street 2:
Mailing Address - City:BROOMFIELD
Mailing Address - State:CO
Mailing Address - Zip Code:80023-8965
Mailing Address - Country:US
Mailing Address - Phone:720-777-9545
Mailing Address - Fax:
Practice Address - Street 1:469 W. STATE HIGHWAY 7
Practice Address - Street 2:SUITE 2
Practice Address - City:BROOMFIELD
Practice Address - State:CO
Practice Address - Zip Code:80023-8965
Practice Address - Country:US
Practice Address - Phone:720-777-9545
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2009-01-15
Last Update Date:2019-09-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QA1903XAmbulatory Health Care FacilitiesClinic/CenterAmbulatory Surgical