Healthcare Provider Details

I. General information

NPI: 1558911586
Provider Name (Legal Business Name): INTEGRATED SURGERY CENTERS LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 09/11/2019
Last Update Date: 10/08/2019
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

10025 E DYNAMITE BLVD STE B150
SCOTTSDALE AZ
85262-3688
US

IV. Provider business mailing address

6929 N HAYDEN RD STE C4-220
SCOTTSDALE AZ
85250-7998
US

V. Phone/Fax

Practice location:
  • Phone: 480-495-5644
  • Fax:
Mailing address:
  • Phone:
  • 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: REBECCA ST GERMAIN
Title or Position: PRESIDENT
Credential:
Phone: 480-562-6939