Provider Demographics
NPI:1962454405
Name:FIRST CHOICE SAME DAY SUGERY CENTER LLC
Entity Type:Organization
Organization Name:FIRST CHOICE SAME DAY SUGERY CENTER LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:EXECUTIVE DIRECTOR
Authorized Official - Prefix:MS
Authorized Official - First Name:LEE ANN
Authorized Official - Middle Name:
Authorized Official - Last Name:SHOBE
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:970-254-2660
Mailing Address - Street 1:2596 F RD
Mailing Address - Street 2:
Mailing Address - City:GRAND JUNCTION
Mailing Address - State:CO
Mailing Address - Zip Code:81505-1443
Mailing Address - Country:US
Mailing Address - Phone:970-254-2660
Mailing Address - Fax:970-254-2665
Practice Address - Street 1:2596 F RD
Practice Address - Street 2:
Practice Address - City:GRAND JUNCTION
Practice Address - State:CO
Practice Address - Zip Code:81505-1443
Practice Address - Country:US
Practice Address - Phone:970-254-2660
Practice Address - Fax:970-254-2665
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-05-16
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CO0896261QA1903X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QA1903XAmbulatory Health Care FacilitiesClinic/CenterAmbulatory Surgical
Provider Identifiers
StateIdentifier IDID TypeIssuer
CO85233854Medicaid
COC445478Medicare UPIN