Provider Demographics
NPI:1346944428
Name:EAST VALLEY AMBULATORY SURGICAL CENTER, LLC
Entity Type:Organization
Organization Name:EAST VALLEY AMBULATORY SURGICAL CENTER, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CHIEF FINANCIAL OFFICER
Authorized Official - Prefix:
Authorized Official - First Name:JASON
Authorized Official - Middle Name:
Authorized Official - Last Name:LOHMEYER
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:847-949-3855
Mailing Address - Street 1:1 PARKWAY NORTH BLVD STE 200S
Mailing Address - Street 2:
Mailing Address - City:DEERFIELD
Mailing Address - State:IL
Mailing Address - Zip Code:60015-2534
Mailing Address - Country:US
Mailing Address - Phone:847-949-3855
Mailing Address - Fax:833-739-2833
Practice Address - Street 1:2394 N ALMA SCHOOL RD STE 1
Practice Address - Street 2:
Practice Address - City:CHANDLER
Practice Address - State:AZ
Practice Address - Zip Code:85224-2459
Practice Address - Country:US
Practice Address - Phone:480-963-0700
Practice Address - Fax:480-776-5737
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2023-03-30
Last Update Date:2023-03-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QA1903XAmbulatory Health Care FacilitiesClinic/CenterAmbulatory Surgical