Provider Demographics
NPI:1891745956
Name:NORTH SUBURBAN SPINE CENTER LP
Entity Type:Organization
Organization Name:NORTH SUBURBAN SPINE CENTER LP
Other - Org Name:NORTH METRO SURGERY CENTER
Other - Org Type:Doing Business As
Authorized Official - Title/Position:VP
Authorized Official - Prefix:
Authorized Official - First Name:WILLIAM
Authorized Official - Middle Name:GREGORY
Authorized Official - Last Name:SWINNEY
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:972-789-2877
Mailing Address - Street 1:9005 GRANT ST
Mailing Address - Street 2:#300
Mailing Address - City:THORNTON
Mailing Address - State:CO
Mailing Address - Zip Code:80229-4300
Mailing Address - Country:US
Mailing Address - Phone:303-288-4694
Mailing Address - Fax:303-288-4697
Practice Address - Street 1:9005 GRANT ST
Practice Address - Street 2:#300
Practice Address - City:THORNTON
Practice Address - State:CO
Practice Address - Zip Code:80229-4300
Practice Address - Country:US
Practice Address - Phone:303-288-4694
Practice Address - Fax:303-288-4697
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-05-11
Last Update Date:2021-12-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CO1186261QA1903X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QA1903XAmbulatory Health Care FacilitiesClinic/CenterAmbulatory Surgical
Provider Identifiers
StateIdentifier IDID TypeIssuer
COC805596Medicare PIN