Provider Demographics
NPI:1407114127
Name:ACUITY SPECIALTY HOSPITAL OF ARIZONA AT MESA, LLC
Entity Type:Organization
Organization Name:ACUITY SPECIALTY HOSPITAL OF ARIZONA AT MESA, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:SVP CFO
Authorized Official - Prefix:MR
Authorized Official - First Name:RICHARD
Authorized Official - Middle Name:LEE
Authorized Official - Last Name:CASSADY
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:704-887-7281
Mailing Address - Street 1:215 S POWER RD
Mailing Address - Street 2:
Mailing Address - City:MESA
Mailing Address - State:AZ
Mailing Address - Zip Code:85206-5235
Mailing Address - Country:US
Mailing Address - Phone:480-985-6992
Mailing Address - Fax:480-981-8390
Practice Address - Street 1:215 S POWER RD
Practice Address - Street 2:
Practice Address - City:MESA
Practice Address - State:AZ
Practice Address - Zip Code:85206-5235
Practice Address - Country:US
Practice Address - Phone:480-985-6992
Practice Address - Fax:480-981-8390
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2012-05-01
Last Update Date:2014-07-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes282E00000XHospitalsLong Term Care Hospital
Provider Identifiers
StateIdentifier IDID TypeIssuer
AZ032007Medicare Oscar/Certification