Provider Demographics
NPI:1154088490
Name:BSC 3 LLC
Entity Type:Organization
Organization Name:BSC 3 LLC
Other - Org Name:BANNER SURGERY CENTER - SPORTS MEDICINE
Other - Org Type:Doing Business As
Authorized Official - Title/Position:DIRECTOR/OFFICER
Authorized Official - Prefix:
Authorized Official - First Name:ARIC
Authorized Official - Middle Name:
Authorized Official - Last Name:BURKE
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:480-689-8403
Mailing Address - Street 1:7400 N DOBSON RD STE 301
Mailing Address - Street 2:
Mailing Address - City:SCOTTSDALE
Mailing Address - State:AZ
Mailing Address - Zip Code:85256-2736
Mailing Address - Country:US
Mailing Address - Phone:602-362-5107
Mailing Address - Fax:
Practice Address - Street 1:7400 N DOBSON RD STE 301
Practice Address - Street 2:
Practice Address - City:SCOTTSDALE
Practice Address - State:AZ
Practice Address - Zip Code:85256-2736
Practice Address - Country:US
Practice Address - Phone:602-362-5107
Practice Address - Fax:602-865-1865
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2021-11-22
Last Update Date:2023-08-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QA1903XAmbulatory Health Care FacilitiesClinic/CenterAmbulatory Surgical