MEDICARE: SURGCENTER TUCSON, LLC

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	261QA1903X	Ambulatory Surgical Clinic/Center

General Provider Information

NPI Number	:	1851710735
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	SURGCENTER TUCSON, LLC

Provider Business Mailing Address
First Line	:	3935 E FORT LOWELL RD
Second Line	:
City	:	TUCSON
State	:	AZ
Zip	:	85712-1009
Country	:	US
Telephone Number	:	520-260-0450
Fax Number	:	520-398-5186

Provider Business Practice Location Address
First Line	:	3945 E FORT LOWELL RD
Second Line	:
City	:	TUCSON
State	:	AZ
Zip	:	85712-1036
Country	:	US
Telephone Number	:	520-260-0450
Fax Number	:

Authorized Official
Title or Position	:	OFFICER/AUTHORIZED OFFICIAL
Name	:	ERIC BOON
Credential	:
Telephone Number	:	480-567-0269

Provider Enumeration Date	:	04/08/2014
Last Update Date	:	04/20/2026

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