Healthcare Provider Details

I. General information

NPI: 1851945984
Provider Name (Legal Business Name): SURGICAL ASSISTANCE LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 07/26/2019
Last Update Date: 07/29/2019
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2925 E RIGGS RD STE 8-195
CHANDLER AZ
85249-4288
US

IV. Provider business mailing address

13843 E VALLEJO ST
CHANDLER AZ
85249-9023
US

V. Phone/Fax

Practice location:
  • Phone: 480-993-6057
  • Fax:
Mailing address:
  • Phone: 480-993-6057
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code163WR0006X
TaxonomyRegistered Nurse First Assistant
License Number
License Number State

VIII. Authorized Official

Name: STEVEN THOMAS TARRENCE
Title or Position: RNFA
Credential: RNFA
Phone: 480-993-6057