Provider Demographics
NPI:1609341841
Name:BASA INC
Entity Type:Organization
Organization Name:BASA INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:SURGICAL FIRST ASSISTANT
Authorized Official - Prefix:
Authorized Official - First Name:ALAN
Authorized Official - Middle Name:CHAD
Authorized Official - Last Name:EDMONSON
Authorized Official - Suffix:
Authorized Official - Credentials:CFA
Authorized Official - Phone:303-870-4937
Mailing Address - Street 1:PO BOX 5073
Mailing Address - Street 2:
Mailing Address - City:ENGLEWOOD
Mailing Address - State:CO
Mailing Address - Zip Code:80155-5073
Mailing Address - Country:US
Mailing Address - Phone:303-870-4937
Mailing Address - Fax:
Practice Address - Street 1:9671 MILLSTONE CT
Practice Address - Street 2:
Practice Address - City:HIGHLANDS RANCH
Practice Address - State:CO
Practice Address - Zip Code:80130-3371
Practice Address - Country:US
Practice Address - Phone:303-870-4937
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2018-10-03
Last Update Date:2018-10-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes246ZC0007XTechnologists, Technicians & Other Technical Service ProvidersSpecialist/Technologist, OtherSurgical AssistantGroup - Single Specialty