Healthcare Provider Details

I. General information

NPI: 1235656174
Provider Name (Legal Business Name): VINCERE SURGERY CENTER LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 08/22/2017
Last Update Date: 03/06/2024
Certification Date: 03/06/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

7469 E MONTE CRISTO AVE
SCOTTSDALE AZ
85260-1618
US

IV. Provider business mailing address

PO BOX 207438
DALLAS TX
75320-7433
US

V. Phone/Fax

Practice location:
  • Phone: 602-331-7811
  • Fax: 602-331-5886
Mailing address:
  • Phone: 480-625-0003
  • Fax: 480-842-8760

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code261QX0200X
TaxonomyOncology Clinic/Center
License Number
License Number State
# 2
Primary TaxonomyY
Taxonomy Code261QA1903X
TaxonomyAmbulatory Surgical Clinic/Center
License Number
License Number State

VIII. Authorized Official

Name: PABLO PRICHARD
Title or Position: SOLE MEMBER
Credential: MD
Phone: 480-625-0003