Provider Demographics
NPI:1205317054
Name:SKYLINE SURGERY CENTER, LLC
Entity type:Organization
Organization Name:SKYLINE SURGERY CENTER, LLC
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:COO
Authorized Official - Prefix:
Authorized Official - First Name:HEATHER
Authorized Official - Middle Name:LEIGH
Authorized Official - Last Name:BARBISH
Authorized Official - Suffix:
Authorized Official - Credentials:COE
Authorized Official - Phone:719-630-3937
Mailing Address - Street 1:3155 N UNION BLVD
Mailing Address - Street 2:
Mailing Address - City:COLORADO SPRINGS
Mailing Address - State:CO
Mailing Address - Zip Code:80907-8703
Mailing Address - Country:US
Mailing Address - Phone:719-630-3937
Mailing Address - Fax:719-635-3578
Practice Address - Street 1:4026 JERRY MURPHY RD
Practice Address - Street 2:
Practice Address - City:PUEBLO
Practice Address - State:CO
Practice Address - Zip Code:81001-1045
Practice Address - Country:US
Practice Address - Phone:719-630-3937
Practice Address - Fax:719-635-3578
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2018-08-28
Last Update Date:2019-04-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QA1903XAmbulatory Health Care FacilitiesClinic/CenterAmbulatory Surgical