Provider Demographics
NPI:1679134795
Name:GREELEY ENDOSCOPY CENTER, LLC
Entity Type:Organization
Organization Name:GREELEY ENDOSCOPY CENTER, LLC
Other - Org Name:NORTHERN COLORADO ENDOSCOPY CENTER
Other - Org Type:Doing Business As
Authorized Official - Title/Position:ADMINISTRATOR
Authorized Official - Prefix:
Authorized Official - First Name:KARISSA
Authorized Official - Middle Name:
Authorized Official - Last Name:HALL
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:970-573-7555
Mailing Address - Street 1:8227 W 20TH ST
Mailing Address - Street 2:
Mailing Address - City:GREELEY
Mailing Address - State:CO
Mailing Address - Zip Code:80634-3039
Mailing Address - Country:US
Mailing Address - Phone:970-573-7555
Mailing Address - Fax:970-744-5309
Practice Address - Street 1:8227 W 20TH ST
Practice Address - Street 2:
Practice Address - City:GREELEY
Practice Address - State:CO
Practice Address - Zip Code:80634-3039
Practice Address - Country:US
Practice Address - Phone:970-420-8863
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2019-06-28
Last Update Date:2023-08-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QA1903XAmbulatory Health Care FacilitiesClinic/CenterAmbulatory Surgical