Healthcare Provider Details

I. General information

NPI: 1780415356
Provider Name (Legal Business Name): GREATER PHX ASC LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 08/13/2024
Last Update Date: 03/21/2025
Certification Date: 03/21/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

3333 E CAMELBACK RD STE 140
PHOENIX AZ
85018-2387
US

IV. Provider business mailing address

3333 E CAMELBACK RD STE 140
PHOENIX AZ
85018-2387
US

V. Phone/Fax

Practice location:
  • Phone: 480-245-7600
  • Fax:
Mailing address:
  • Phone: 480-245-7600
  • 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: MR. RYAN C STRAND
Title or Position: COO
Credential: COO
Phone: 480-245-7600