NPIMap

Animas Surgical Hospital, LLC

Organization Active NPI Family Medicine Physician · Durango, CO

NPI 1235313693 · NPPES record last updated Feb 8, 2023

Key facts

NPI
1235313693
Entity type
Organization (NPI type 2)
Primary specialty
Family Medicine Physician 207Q00000X
License
0109 (CO)
Legal business name
ANIMAS SURGICAL HOSPITAL, LLC
Practice address
575 Rivergate Lane
#105
Durango, CO 81301
Phone
(970) 385-2344
Fax
(405) 841-9354
NPI assigned
Dec 20, 2007
Organization subpart
Yes
Parent organization (as reported)
ANIMAS SURGICAL HOSPITAL, LLC

Authorized official

Name
Jennifer Boyd Baldock
Title
Officer and Authorized Official
Phone
(615) 234-5954

Corporate family (same tax ID) 5

Organizations that report the same tax identification number in the National Provider Directory.

National Provider Directory

Tax ID family
Animas Surgical Hospital LL (6 organizations share this tax ID)
Part of
Animas Surgical Hospital LL

Specialties & licenses

Specialty (taxonomy)CodeLicenseStatePrimary
Family Medicine Physician
Group: 193400000X SINGLE SPECIALTY GROUP		 207Q00000X 0109 CO Yes

Addresses

Primary practice location

575 Rivergate Lane
#105
Durango, CO 81301

Mailing address

6128 S Lyncrest Ave
Sioux Falls, SD 57108-2560
Phone (888) 955-0501

Other identifiers

IdentifierTypeStateIssuer
34172271MedicaidCO

Other names

  • Animas Family Medicine Doing business as

Other providers in Durango, CO

All providers in Durango, CO · Family Medicine Physician in Colorado

Sources for this page

Verify at the official NPI Registry.