Basic Information
| Provider Information | |||||||||
| NPI: | 1447799044 | ||||||||
| EntityType: | 2 | ||||||||
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| OrganizationName: | GREENWOOD ASC, LLC | ||||||||
| LastName: | |||||||||
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| OtherOrganizationName: | COLORADO PREMIER SURGERY CENTER AT LAKEWOOD | ||||||||
| OtherOrganizationType: | 3 | ||||||||
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| Mailing Information | |||||||||
| Address1: | 355 UNION BLVD | ||||||||
| Address2: | |||||||||
| City: | LAKEWOOD | ||||||||
| State: | CO | ||||||||
| PostalCode: | 802286516 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 9727633893 | ||||||||
| FaxNumber: | 3036898700 | ||||||||
| Practice Location | |||||||||
| Address1: | 355 UNION BLVD STE 10 | ||||||||
| Address2: | |||||||||
| City: | LAKEWOOD | ||||||||
| State: | CO | ||||||||
| PostalCode: | 802281500 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 9727633893 | ||||||||
| FaxNumber: | 9726926745 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 02/15/2017 | ||||||||
| LastUpdateDate: | 07/23/2021 | ||||||||
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| ProviderGenderCode: | |||||||||
| AuthorizedOfficialLastName: | DANNA | ||||||||
| AuthorizedOfficialFirstName: | TERESA | ||||||||
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| AuthorizedOfficialTitleorPosition: | OFFICER / AUTHORIZED OFFICIAL | ||||||||
| AuthorizedOfficialTelephone: | 9727633890 | ||||||||
| IsSoleProprietor: | |||||||||
| IsOrganizationSubpart: | N | ||||||||
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| NPICertificationDate: | 07/23/2021 | ||||||||
Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 261QA1903X | Y | Ambulatory Health Care Facilities | Clinic/Center | Ambulatory Surgical |
No ID Information.