MODERN AMBULATORY SURGERY CENTER PC NPI 1982031936

NPI Information

NPI: 1982031936
Provider Name: MODERN AMBULATORY SURGERY CENTER, PC
Classification: Clinic/Center - 261QA1903X
Entity Type: Organization

Specialization: Ambulatory Surgical

CLIA Number: 03D2053506

Address:
4860 E BASELINE ROAD
SUITE 101
MESA, AZ
ZIP 85206
Phone: (602) 265-8800
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MODERN AMBULATORY SURGERY CENTER, PC is an ambulatory surgical clinic center in Mesa, AZ. MODERN AMBULATORY SURGERY CENTER, PC NPI is 1982031936. The provider is registered as an organization entity type.

The provider's business location address is:

4860 E BASELINE ROAD
SUITE 101
MESA, AZ
ZIP 85206-670
Phone: (602) 265-8800
Fax: (602) 265-8151

The provider's authorized official is Leslie Daugherty .
The authorized official title is Administrator and has the following contact phone number (602) 265-8800.

The CLIA number assigned to this NPI record is 03D2053506 - ambulatory surgery center with a certificate type of Certificate of Waiver.

The enumeration date for this NPI number is 10/7/2013 and was last updated on 10/7/2013.

Taxonomy Codes

The NPI record includes the healthcare provider taxonomy classification, state license number and state of licensure. The following information regarding the scope of practice of this provider is available:

No.	Taxonomy Code	Taxonomy Clasification	Taxonomy Specialization	License Number	License State	Primary
1	261QA1903X	Clinic/Center	Ambulatory Surgical			Yes

What is NPI?

NPI stands for National Provider Identifier. The NPI is a 10-digit identification number that is completely unique. The NPI number by itself does not contain any identifiable information such as a provider’s speciality or location. The NPI is assigned to individuals or organizacions for their lifespan and it is independent of key provider information type updates like a change of practices, location or speciality.

This page was last updated on: 5/5/2024

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