SRP FACILITY NPI 1801189519

NPI Information

SRP FACILITY is a pain clinic center in Phoenix, AZ. SRP FACILITY NPI is 1801189519. The provider is registered as an organization entity type.

The provider's business location address is:

3330 N 2ND ST
SUITE 200
PHOENIX, AZ
ZIP 85012-368
Phone: (602) 889-9880

The provider's authorized official is Sanjay R Patel .
The authorized official title is Medical Director/owner and has the following contact phone number (602) 889-9880.

The CLIA number assigned to this NPI record is 03D2277308 - other - outpatient treatment cent with a certificate type of Certificate of Waiver.

The enumeration date for this NPI number is 5/27/2011 and was last updated on 5/27/2011.

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:

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