SURGERY CENTER OF PEORIA LLC NPI 1992706899

NPI Information

SURGERY CENTER OF PEORIA, LLC is an ambulatory surgical clinic center in Peoria, AZ. SURGERY CENTER OF PEORIA, LLC NPI is 1992706899. The provider is registered as an organization entity type.
The provider Other Name Is Surgery Center Of Peoria.

The provider's business location address is:

13260 N 94TH DR
SUITE 200
PEORIA, AZ
ZIP 85381-828
Phone: (623) 933-2900
Fax: (623) 933-0017

The provider's authorized official is Eric Boon .
The authorized official title is Officer/authorized Official and has the following contact phone number (480) 567-0269.

The CLIA number assigned to this NPI record is 03D0967686 - ambulatory surgery center with a certificate type of Certificate of Waiver.

The enumeration date for this NPI number is 8/2/2005 and was last updated on 9/21/2021.

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:

Other Identifiers

The following information regarding additional identifiers associated to this NPI record includes the other identifier number, identifier type, identifier state and issuer.

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