BANNER ENTICARE TEMPE SURGERY CENTER LLC NPI 1437615929

NPI Information

NPI: 1437615929
Provider Name: BANNER ENTICARE TEMPE SURGERY CENTER LLC

Doing Business As: BANNER TEMPE SURGERY CENTER

Classification: Clinic/Center - 261QA1903X
Entity Type: Organization

Specialization: Ambulatory Surgical

Address:
1940 E SOUTHERN AVE
TEMPE, AZ
ZIP 85282
Phone: (480) 820-7101
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BANNER ENTICARE TEMPE SURGERY CENTER LLC is an ambulatory surgical clinic center in Tempe, AZ. BANNER ENTICARE TEMPE SURGERY CENTER LLC NPI is 1437615929. The provider is registered as an organization entity type.
The provider Is Doing Business As Banner Tempe Surgery Center.

The provider's business location address is:

1940 E SOUTHERN AVE
TEMPE, AZ
ZIP 85282-518
Phone: (480) 820-7101

The provider's authorized official is Homan Mostafavi .
The authorized official title is Manager-member and has the following contact phone number (248) 229-6188.

The CLIA number assigned to this NPI record is 03D2164221 - ambulatory surgery center with a certificate type of Certificate of Waiver.

The enumeration date for this NPI number is 2/20/2019 and was last updated on 2/11/2020.

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: 4/28/2024

NPI Synchronization or Removal

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