Healthcare Provider Details

I. General information

NPI: 1548789183
Provider Name (Legal Business Name): VALLEY SURGERY CENTER III LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 09/14/2017
Last Update Date: 09/20/2023
Certification Date: 09/20/2023
Deactivation Date:
Reactivation Date:

III. Provider practice location address

9458 E IRONWOOD SQUARE DR STE 101
SCOTTSDALE AZ
85258-4571
US

IV. Provider business mailing address

9458 E IRONWOOD SQUARE DR STE 101
SCOTTSDALE AZ
85258-4571
US

V. Phone/Fax

Practice location:
  • Phone: 602-603-0300
  • Fax:
Mailing address:
  • Phone: 602-975-0123
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code261QA1903X
TaxonomyAmbulatory Surgical Clinic/Center
License NumberOSC8697
License Number StateAZ
# 2
Primary TaxonomyY
Taxonomy Code261QA1903X
TaxonomyAmbulatory Surgical Clinic/Center
License Number
License Number State

VIII. Authorized Official

Name: ABHISHIEK SHARMA
Title or Position: MANAGER
Credential: MD
Phone: 602-975-0123