Provider Demographics
NPI:1376998666
Name:SWAN SURGERY CENTER, LLC
Entity Type:Organization
Organization Name:SWAN SURGERY CENTER, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:FADI
Authorized Official - Middle Name:
Authorized Official - Last Name:DEEB
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:520-795-3090
Mailing Address - Street 1:1505 N SWAN RD
Mailing Address - Street 2:
Mailing Address - City:TUCSON
Mailing Address - State:AZ
Mailing Address - Zip Code:85712-4078
Mailing Address - Country:US
Mailing Address - Phone:520-795-3090
Mailing Address - Fax:
Practice Address - Street 1:1505 N SWAN RD # 101
Practice Address - Street 2:
Practice Address - City:TUCSON
Practice Address - State:AZ
Practice Address - Zip Code:85712-4044
Practice Address - Country:US
Practice Address - Phone:520-795-3090
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2016-04-25
Last Update Date:2020-02-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
261QA1903X
AZ0000000261QA1903X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QA1903XAmbulatory Health Care FacilitiesClinic/CenterAmbulatory Surgical