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General NPI Number Information
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NPI Number | 1306843222
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Entity Type | Organization
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Legal Business Name | ST. JOSEPH'S OUTPATIENT SURGERY CENTER, LLC
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Dates
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Enumeration Date | 07/07/2005
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Last Update Date | 01/16/2025
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Provider Practice Location Address
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Address Line | 240 W THOMAS RD
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City | PHOENIX
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State | AZ
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Zip | 85013-4407
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Country | US
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Telephone | 602-406-3552
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Fax | 602-406-7139
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Provider Business Mailing Address
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Address Line | 240 W THOMAS RD
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City | PHOENIX
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State | AZ
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Zip | 85013-4407
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Country | US
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Telephone | 602-406-3552
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Fax | 602-406-7139
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Authorized Official
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Title or Position | OFFICER/AUTHORIZED OFFICIAL
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Name | ERIC BOON
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Credential |
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Telephone | 480-567-0269
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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 | OSC3456
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License Number State | AZ
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