Provider Demographics
NPI:1689003766
Name:CANYON VIEW SURGERY CENTER, LLC
Entity Type:Organization
Organization Name:CANYON VIEW SURGERY CENTER, LLC
Other - Org Name:CANYON VIEW ASC
Other - Org Type:Doing Business As
Authorized Official - Title/Position:PRESIDENT AND CEO
Authorized Official - Prefix:MR
Authorized Official - First Name:CHRISTIAN
Authorized Official - Middle Name:
Authorized Official - Last Name:THOMAS
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:970-644-3011
Mailing Address - Street 1:2373 G ROAD
Mailing Address - Street 2:SUITE 180
Mailing Address - City:GRAND JUNCTION
Mailing Address - State:CO
Mailing Address - Zip Code:81505
Mailing Address - Country:US
Mailing Address - Phone:970-773-2350
Mailing Address - Fax:970-773-2351
Practice Address - Street 1:2373 G ROAD
Practice Address - Street 2:SUITE 180
Practice Address - City:GRAND JUNCTION
Practice Address - State:CO
Practice Address - Zip Code:81505
Practice Address - Country:US
Practice Address - Phone:970-773-2350
Practice Address - Fax:970-773-2351
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2013-11-08
Last Update Date:2023-01-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QA1903XAmbulatory Health Care FacilitiesClinic/CenterAmbulatory Surgical
Provider Identifiers
StateIdentifier IDID TypeIssuer
CO27125076Medicaid
CO06C0001146Medicare UPIN