Healthcare Provider Details

I. General information

NPI: 1003556812
Provider Name (Legal Business Name): BSC 2 LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 03/30/2022
Last Update Date: 07/13/2022
Certification Date: 07/13/2022
Deactivation Date:
Reactivation Date:

III. Provider practice location address

9439 E IRONWOOD SQUARE DR STE 100
SCOTTSDALE AZ
85258-4573
US

IV. Provider business mailing address

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

V. Phone/Fax

Practice location:
  • Phone: 480-355-3750
  • 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: DIRECTOR/OFFICER
Credential:
Phone: 480-689-8403