Provider Demographics
NPI:1144333881
Name:NORTH SCOTTSDALE AMBULATORY SURGERY CENTER, LLC
Entity type:Organization
Organization Name:NORTH SCOTTSDALE AMBULATORY SURGERY CENTER, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OFFICER/DIRECTOR
Authorized Official - Prefix:
Authorized Official - First Name:ARIC
Authorized Official - Middle Name:
Authorized Official - Last Name:BURKE
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:480-689-8403
Mailing Address - Street 1:9439 E IRONWOOD SQUARE DR STE 100
Mailing Address - Street 2:
Mailing Address - City:SCOTTSDALE
Mailing Address - State:AZ
Mailing Address - Zip Code:85258-4573
Mailing Address - Country:US
Mailing Address - Phone:480-355-3750
Mailing Address - Fax:480-355-3753
Practice Address - Street 1:9439 E IRONWOOD SQUARE DR STE 100
Practice Address - Street 2:
Practice Address - City:SCOTTSDALE
Practice Address - State:AZ
Practice Address - Zip Code:85258-4573
Practice Address - Country:US
Practice Address - Phone:480-355-3750
Practice Address - Fax:480-355-3753
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-08-16
Last Update Date:2022-01-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AZOSC 3647261QA1903X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QA1903XAmbulatory Health Care FacilitiesClinic/CenterAmbulatory Surgical
Provider Identifiers
StateIdentifier IDID TypeIssuer
AZ912669Medicaid
AZZ100797Medicare ID - Type Unspecified