Healthcare Provider Details
I. General information
NPI: 1952799900
Provider Name (Legal Business Name): DESERT ANCILLARY SERVICES PLLC
Entity Type: Organization
Gender:
Sole Proprietor:
II. Dates (important events)
Enumeration Date: 12/29/2014
Last Update Date: 12/29/2014
Certification Date:
Deactivation Date:
Reactivation Date:
III. Provider practice location address
10115 E BELL RD SUITE 107-508
SCOTTSDALE AZ
85260-2189
US
IV. Provider business mailing address
10115 E BELL RD SUITE 107-508
SCOTTSDALE AZ
85260-2189
US
V. Phone/Fax
- Phone: 602-999-5471
- Fax: 480-247-6146
- Phone: 602-999-5471
- Fax: 480-247-6146
VI. Provider taxonomy
Scope of Practice (Provider specialty)
| # 1 | |
| Primary Taxonomy | Y |
| Taxonomy Code | 364SP2800X |
| Taxonomy | Perioperative Clinical Nurse Specialist |
| License Number | |
| License Number State | |
VIII. Authorized Official
Name: DR.
DUANE
DH
PITT
Title or Position: OWNER/PHYSICIAN
Credential: MD
Phone: 602-999-5471