Provider Demographics
NPI:1083104186
Name:VALLEY SURGICAL CENTER LLC
Entity Type:Organization
Organization Name:VALLEY SURGICAL CENTER LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:ADMINISTRATOR
Authorized Official - Prefix:
Authorized Official - First Name:CINDY
Authorized Official - Middle Name:
Authorized Official - Last Name:MEEHAN
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:602-863-6363
Mailing Address - Street 1:15601 N 28TH AVE STE 101
Mailing Address - Street 2:
Mailing Address - City:PHOENIX
Mailing Address - State:AZ
Mailing Address - Zip Code:85053-4061
Mailing Address - Country:US
Mailing Address - Phone:602-863-6363
Mailing Address - Fax:602-863-6611
Practice Address - Street 1:15601 N 28TH AVE STE 101
Practice Address - Street 2:
Practice Address - City:PHOENIX
Practice Address - State:AZ
Practice Address - Zip Code:85053-4061
Practice Address - Country:US
Practice Address - Phone:602-863-6363
Practice Address - Fax:602-863-6611
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:PHOENIX ORTHOPAEDIC SURGEONS, LTD
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2018-05-14
Last Update Date:2018-12-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QA1903XAmbulatory Health Care FacilitiesClinic/CenterAmbulatory Surgical