Provider Demographics
NPI:1659638559
Name:STATCALL SURGICAL ASSISTING
Entity Type:Organization
Organization Name:STATCALL SURGICAL ASSISTING
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:SUGICAL FIRST ASSIST
Authorized Official - Prefix:MR
Authorized Official - First Name:ALAN
Authorized Official - Middle Name:CHAD
Authorized Official - Last Name:EDMONSON
Authorized Official - Suffix:
Authorized Official - Credentials:CST/CSFA
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:281-462-1554
Practice Address - Street 1:10084 AMSTON ST
Practice Address - Street 2:
Practice Address - City:PARKER
Practice Address - State:CO
Practice Address - Zip Code:80134-3658
Practice Address - Country:US
Practice Address - Phone:281-462-1285
Practice Address - Fax:281-462-1554
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2012-04-16
Last Update Date:2014-03-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
COSA.0001554246ZC0007X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes246ZC0007XTechnologists, Technicians & Other Technical Service ProvidersSpecialist/Technologist, OtherSurgical AssistantGroup - Single Specialty