| Organization Name: | RIDGELINE ENDOSCOPY CENTER L.C. |
| NPI Number: | 1154304749 |
| Entity Type Code: | Organizational (2) |
| Authorized Official Name: | JOHN LOWE (GENERAL PARTNER) |
| Mailing Address: | 6028 S Ridgeline Dr Suite 100 South Ogden |
| State: | UT US |
| Postal Code: | 844056914 |
| Phone Number: | 8014754988 |
| Fax Number: | 8014754948 |
| NPI Enumeration Date: | 11/28/2005 |
| NPI Last Update Date: | 07/08/2007 |
| Replacement NPI: | 0 |
| NPI Deactivation Date: | |
| NPI Reactivation Date: |
Taxonomy Information: | |
| Healthcare Provider Taxonomy: | 261QA1903X |
| License Number: | 2004-ASF-9993 |
| Healthcare Provider Taxonomy: (Secondary) | Y |
| State: | UT |
| Taxonomy Type: | Ambulatory Health Care Facilities |
| Taxonomy Classification: | Clinic/Center |
| Taxonomy Specialization: | Ambulatory Surgical |
| Taxonomy Definition: | |