Healthcare Provider Details

I. General information

NPI: 1013676444
Provider Name (Legal Business Name): APS SURGICAL CENTER, LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 12/13/2021
Last Update Date: 12/13/2021
Certification Date: 12/13/2021
Deactivation Date:
Reactivation Date:

III. Provider practice location address

6859 E REMBRANDT AVE STE 114
MESA AZ
85212-3629
US

IV. Provider business mailing address

15333 N PIMA RD STE 305
SCOTTSDALE AZ
85260-2717
US

V. Phone/Fax

Practice location:
  • Phone: 480-640-1232
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code261QA1903X
TaxonomyAmbulatory Surgical Clinic/Center
License Number
License Number State

VII. Legacy identifiers

For crosswalk purposes, the following legacy (non-NPI) identifiers are available for this provider:

VIII. Authorized Official

Name: GRANT COOK
Title or Position: MANAGER
Credential:
Phone: 480-640-1232