Provider Demographics
NPI:1679836431
Name:COLORADO SURGICAL SERVICES LLC
Entity Type:Organization
Organization Name:COLORADO SURGICAL SERVICES LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CEO
Authorized Official - Prefix:MR
Authorized Official - First Name:MARK
Authorized Official - Middle Name:A
Authorized Official - Last Name:RAHE
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:720-988-7801
Mailing Address - Street 1:5599 S FENTON ST
Mailing Address - Street 2:
Mailing Address - City:LITTLETON
Mailing Address - State:CO
Mailing Address - Zip Code:80123-0682
Mailing Address - Country:US
Mailing Address - Phone:720-988-7801
Mailing Address - Fax:
Practice Address - Street 1:5599 S FENTON ST
Practice Address - Street 2:
Practice Address - City:LITTLETON
Practice Address - State:CO
Practice Address - Zip Code:80123-0682
Practice Address - Country:US
Practice Address - Phone:720-988-7801
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2012-06-18
Last Update Date:2012-06-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes247200000XTechnologists, Technicians & Other Technical Service ProvidersTechnician, OtherGroup - Single Specialty