Healthcare Provider Details

I. General information

NPI: 1821366006
Provider Name (Legal Business Name): SCOTTSDALE SURGERY CENTER
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 12/02/2011
Last Update Date: 01/16/2020
Certification Date: 01/16/2020
Deactivation Date:
Reactivation Date:

III. Provider practice location address

8900 E RAINTREE DR
SCOTTSDALE AZ
85260-7307
US

IV. Provider business mailing address

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

V. Phone/Fax

Practice location:
  • Phone: 480-752-7874
  • Fax:
Mailing address:
  • Phone: 480-752-7874
  • 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: PABLO ANDRES PRICHARD
Title or Position: DIRECTOR
Credential: MD
Phone: 602-331-7811