Organization · NPI-2

16th Street Surgery Center, LLC

Clinic/Center, Ambulatory Surgical · Phoenix, AZ

NPI number1629535950
StatusActive
Last updated in NPPESFeb 22, 2019

Details

NPI
1629535950
Entity type
Organization (NPI-2)
Legal business name
16th Street Surgery Center, LLC
Organization subpart
No
Enumeration date
Feb 22, 2019
Last updated
Feb 22, 2019

Taxonomy and licenses

Taxonomy codeDescriptionLicenseStatePrimary
261QA1903X Clinic/Center, Ambulatory Surgical––Yes

Practice location

6245 N 16th St
Phoenix, AZ 85016-1706

Phone 480-766-6819

Mailing address

15333 N Pima Rd Ste 305
Scottsdale, AZ 85260-2717

Authorized official

Grant Cook
Owner/Manager
4807666819

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