Healthcare Provider Details

I. General information

NPI: 1205502440
Provider Name (Legal Business Name): VHC-V LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 08/18/2021
Last Update Date: 08/18/2021
Certification Date: 08/18/2021
Deactivation Date:
Reactivation Date:

III. Provider practice location address

8900 E RAINTREE DR STE 100
SCOTTSDALE AZ
85260-7307
US

IV. Provider business mailing address

11811 N TATUM BLVD STE 3031
PHOENIX AZ
85028-1621
US

V. Phone/Fax

Practice location:
  • Phone: 602-753-4133
  • Fax:
Mailing address:
  • Phone: 602-753-4133
  • Fax: 602-666-0251

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: SUSAN NANCE
Title or Position: COO
Credential: RN
Phone: 602-753-4133