Healthcare Provider Details

I. General information

NPI: 1013539709
Provider Name (Legal Business Name): BSC BILTMORE LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 05/15/2020
Last Update Date: 05/15/2020
Certification Date: 05/15/2020
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2222 E HIGHLAND AVE STE 100
PHOENIX AZ
85016-4874
US

IV. Provider business mailing address

2355 E CAMELBACK RD STE 700
PHOENIX AZ
85016-9044
US

V. Phone/Fax

Practice location:
  • Phone: 602-358-8512
  • Fax:
Mailing address:
  • Phone: 602-358-8512
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

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

VIII. Authorized Official

Name: ARIC BURKE
Title or Position: VICE PRESIDENT OF MANAGER
Credential:
Phone: 602-670-1613