MEDICARE: DESERT SUN SURGERY CENTER LLC

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	261QA1903X	Ambulatory Surgical Clinic/Center

General Provider Information

NPI Number	:	1811940398
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	DESERT SUN SURGERY CENTER LLC

Provider Business Mailing Address
First Line	:	7140 E ROSEWOOD ST
Second Line	:
City	:	TUCSON
State	:	AZ
Zip	:	85710-1346
Country	:	US
Telephone Number	:	520-547-4600
Fax Number	:	520-547-4605

Provider Business Practice Location Address
First Line	:	7140 E ROSEWOOD ST
Second Line	:	SUITE A
City	:	TUCSON
State	:	AZ
Zip	:	85710-1346
Country	:	US
Telephone Number	:	520-547-4600
Fax Number	:	520-547-4605

Authorized Official
Title or Position	:	MEDICAL DIRECTOR
Name	:	CRAIG G GROSS
Credential	:	M.D.
Telephone Number	:	520-547-4600

Provider Enumeration Date	:	05/18/2006
Last Update Date	:	04/18/2013

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