Provider Demographics
NPI:1649871450
Name:ADVANCED HEART AND VEIN SURGERY CENTER, LLC
Entity type:Organization
Organization Name:ADVANCED HEART AND VEIN SURGERY CENTER, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:RAJESH
Authorized Official - Middle Name:
Authorized Official - Last Name:SHARMA
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:720-272-2828
Mailing Address - Street 1:805 E 144TH AVE STE 200
Mailing Address - Street 2:
Mailing Address - City:THORNTON
Mailing Address - State:CO
Mailing Address - Zip Code:80023-9210
Mailing Address - Country:US
Mailing Address - Phone:720-893-5000
Mailing Address - Fax:720-792-5001
Practice Address - Street 1:805 E 144TH AVE STE 200
Practice Address - Street 2:
Practice Address - City:THORNTON
Practice Address - State:CO
Practice Address - Zip Code:80023-9210
Practice Address - Country:US
Practice Address - Phone:720-893-5000
Practice Address - Fax:720-792-5001
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2020-11-06
Last Update Date:2021-09-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QA1903XAmbulatory Health Care FacilitiesClinic/CenterAmbulatory Surgical