Healthcare Provider Details
I. General information
NPI: 1003324856
Provider Name (Legal Business Name): ARCADIA COMMONS SURGERY CENTER, LLC
Entity Type: Organization
Gender:
Sole Proprietor:
II. Dates (important events)
Enumeration Date: 01/15/2018
Last Update Date: 01/15/2018
Certification Date:
Deactivation Date:
Reactivation Date:
III. Provider practice location address
2629 N SCOTTSDALE RD
SCOTTSDALE AZ
85257-1370
US
IV. Provider business mailing address
3724 N 3RD ST STE 301
PHOENIX AZ
85012-2035
US
V. Phone/Fax
- Phone: 602-714-8185
- Fax: 602-714-8117
- Phone: 602-714-8185
- Fax: 602-714-8117
VI. Provider taxonomy
Scope of Practice (Provider specialty)
| # 1 | |
| Primary Taxonomy | Y |
| Taxonomy Code | 261QA1903X |
| Taxonomy | Ambulatory Surgical Clinic/Center |
| License Number | |
| License Number State | |
VIII. Authorized Official
Name:
MELISSA
SHIELDS
Title or Position: PROGRAM DIRECTOR
Credential:
Phone: 602-714-8185