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General NPI Number Information
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NPI Number | 1902881295
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Entity Type | Organization
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Legal Business Name | SURGICAL SPECIALTY HOSPITAL OF ARIZONA, LLC
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Dates
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Enumeration Date | 12/09/2005
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Last Update Date | 04/17/2025
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Provider Practice Location Address
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Address Line | 6501 N 19TH AVE
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City | PHOENIX
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State | AZ
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Zip | 85015-1646
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Country | US
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Telephone | 602-795-6020
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Fax | 602-795-6022
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Provider Business Mailing Address
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Address Line | 6501 N 19TH AVE
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City | PHOENIX
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State | AZ
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Zip | 85015-1646
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Country | US
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Telephone | 602-795-6020
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Fax | 602-795-6022
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Authorized Official
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Title or Position | CHIEF OF ADMINISTRATION & STAFF OFF
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Name | ERIC TOMLON
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Credential |
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Telephone | 623-537-5605
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 261QM1200X
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Taxonomy Name | Magnetic Resonance Imaging (MRI) Clinic/Center
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License Number |
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License Number State |
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Taxonomy #2
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Taxonomy Code | 284300000X
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Taxonomy Name | Special Hospital
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License Number |
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License Number State |
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