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General NPI Number Information
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NPI Number | 1184078503
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Entity Type | Organization
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Legal Business Name | PIMA HEART ASC LLC
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Dates
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Enumeration Date | 04/21/2016
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Last Update Date | 07/21/2022
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Provider Practice Location Address
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Address Line | 1238 W ORANGE GROVE RD SUITE# 101
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City | TUCSON
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State | AZ
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Zip | 85704
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Country | US
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Telephone | 520-838-2300
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Fax | 520-838-2229
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Provider Business Mailing Address
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Address Line | 3709 N CAMPBELL AVE #201
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City | TUCSON
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State | AZ
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Zip | 85719
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Country | US
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Telephone | 520-320-3918
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Fax | 520-629-9430
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Authorized Official
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Title or Position | CEO
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Name | CLAUDIA RASNAKE
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Credential |
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Telephone | 520-838-1711
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 261QA1903X
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Taxonomy Name | Ambulatory Surgical Clinic/Center
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License Number |
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License Number State | AZ
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Taxonomy #2
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Taxonomy Code | 261QA1903X
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Taxonomy Name | Ambulatory Surgical Clinic/Center
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License Number | OSC8295
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License Number State | AZ
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