Healthcare Provider Details

I. General information

NPI: 1497171714
Provider Name (Legal Business Name): YUMA SURGERY CENTER, LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 03/11/2014
Last Update Date: 11/20/2014
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

275 W 28TH ST SUITE 2
YUMA AZ
85364-7308
US

IV. Provider business mailing address

275 W 28TH ST SUITE 2
YUMA AZ
85364-7308
US

V. Phone/Fax

Practice location:
  • Phone: 928-329-5011
  • Fax: 928-248-8569
Mailing address:
  • Phone: 928-329-5011
  • Fax: 928-248-8569

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: MARLENE D AIELLO
Title or Position: ADMINISTRATOR
Credential: RN
Phone: 928-329-5011