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NPI 1760968234

NPI 1760968234 : COMPREHENSIVE SURGICAL CARE LLC : SUN CITY, AZ

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General NPI Number Information
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    NPI Number           |    1760968234
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    Entity Type          |    Organization 
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    Legal Business Name  |    COMPREHENSIVE SURGICAL CARE LLC 
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Dates
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    Enumeration Date     |    07/17/2018
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    Last Update Date     |    07/17/2018
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Provider Practice Location Address
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    Address Line         |    14642 N DEL WEBB BLVD 
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    City                 |    SUN CITY
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    State                |    AZ
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    Zip                  |    85351-2147
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    Country              |    US
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    Telephone            |    480-374-7354
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    Fax                  |    480-371-1121
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Provider Business Mailing Address
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    Address Line         |    4001 E BASELINE RD STE 107 
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    City                 |    GILBERT
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    State                |    AZ
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    Zip                  |    85234-2744
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    Country              |    US
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    Telephone            |    480-374-7354
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    Fax                  |    480-371-1121
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Authorized Official
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    Title or Position    |    PRESIDENT
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    Name                 |     JOEL R RAINWATER 
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    Credential           |    MD
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    Telephone            |    480-374-7354
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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 |    
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