Provider Demographics
NPI:1386000495
Name:CENTRAL ARIZONA SURGERY CENTER
Entity Type:Organization
Organization Name:CENTRAL ARIZONA SURGERY CENTER
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER/DOCTOR
Authorized Official - Prefix:DR
Authorized Official - First Name:GEORGE
Authorized Official - Middle Name:ROGER
Authorized Official - Last Name:EDELEN
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:520-836-8644
Mailing Address - Street 1:1653 E. MCMURRAY BLVD
Mailing Address - Street 2:STE 141
Mailing Address - City:CASA GRANDE
Mailing Address - State:AZ
Mailing Address - Zip Code:85122-5934
Mailing Address - Country:US
Mailing Address - Phone:520-233-6502
Mailing Address - Fax:520-233-6816
Practice Address - Street 1:1653 E MCMURRAY BLVD
Practice Address - Street 2:SUITE 141
Practice Address - City:CASA GRANDE
Practice Address - State:AZ
Practice Address - Zip Code:85122-5934
Practice Address - Country:US
Practice Address - Phone:520-836-8644
Practice Address - Fax:480-359-3892
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2016-01-05
Last Update Date:2024-03-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QA1903XAmbulatory Health Care FacilitiesClinic/CenterAmbulatory Surgical