QUEEN CREEK SURGICAL CENTER LLC NPI 1639605595

NPI Information

NPI: 1639605595
Provider Name: QUEEN CREEK SURGICAL CENTER, LLC
Classification: Clinic/Center - 261QA1903X
Entity Type: Organization

Specialization: Ambulatory Surgical

CLIA Number: 03D2137152

Address:
36453 N GANTZEL RD
SAN TAN VALLEY, AZ
ZIP 85140
Phone: (480) 636-1225
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QUEEN CREEK SURGICAL CENTER, LLC is an ambulatory surgical clinic center in San Tan Valley, AZ. QUEEN CREEK SURGICAL CENTER, LLC NPI is 1639605595. The provider is registered as an organization entity type.

The provider's business location address is:

36453 N GANTZEL RD
SAN TAN VALLEY, AZ
ZIP 85140-339
Phone: (480) 636-1225
Fax: (480) 636-8890

The provider's authorized official is Aric Burke .
The authorized official title is Director/officer and has the following contact phone number (480) 689-8403.

The CLIA number assigned to this NPI record is 03D2137152 - ambulatory surgery center with a certificate type of Certificate of Waiver.

The enumeration date for this NPI number is 5/11/2017 and was last updated on 9/29/2023.

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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