| Organization Name: | LONGMONT SURGERY CENTER, LLC |
| NPI Number: | 1063582427 |
| Entity Type Code: | Organizational (2) |
| Authorized Official Name: | SEAN MANION (PRESIDENT) |
| Mailing Address: | 2030 W Mountain View Ave # 100 Longmont |
| State: | CO US |
| Postal Code: | 80501 |
| Phone Number: | 3036820375 |
| Fax Number: | 3036820593 |
| NPI Enumeration Date: | 11/09/2006 |
| NPI Last Update Date: | 08/05/2009 |
| Replacement NPI: | 0 |
| NPI Deactivation Date: | |
| NPI Reactivation Date: |
Taxonomy Information: | |
| Healthcare Provider Taxonomy: | 261QA1903X |
| License Number: | 1112 |
| Healthcare Provider Taxonomy: (Secondary) | Y |
| State: | CO |
| Taxonomy Type: | Ambulatory Health Care Facilities |
| Taxonomy Classification: | Clinic/Center |
| Taxonomy Specialization: | Ambulatory Surgical |
| Taxonomy Definition: | |