Provider Demographics
NPI:1467169474
Name:BOR SURGICAL FIRST ASSIST PLLC
Entity Type:Organization
Organization Name:BOR SURGICAL FIRST ASSIST PLLC
Other - Org Name:BOR SURGICAL FIRST ASSIST PLLC
Other - Org Type:Doing Business As
Authorized Official - Title/Position:RN
Authorized Official - Prefix:MRS
Authorized Official - First Name:BARBARA
Authorized Official - Middle Name:M
Authorized Official - Last Name:ORTEGA-RUTHERFORD
Authorized Official - Suffix:
Authorized Official - Credentials:RN
Authorized Official - Phone:520-444-2753
Mailing Address - Street 1:10582 E RALPH ALVAREZ PL
Mailing Address - Street 2:
Mailing Address - City:TUCSON
Mailing Address - State:AZ
Mailing Address - Zip Code:85747-5885
Mailing Address - Country:US
Mailing Address - Phone:520-444-2753
Mailing Address - Fax:520-296-2738
Practice Address - Street 1:5301 E GRANT RD
Practice Address - Street 2:
Practice Address - City:TUCSON
Practice Address - State:AZ
Practice Address - Zip Code:85712-2805
Practice Address - Country:US
Practice Address - Phone:520-327-5461
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:BOR SURGICAL FIRST ASSIST PLLC
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2022-10-31
Last Update Date:2022-12-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes163W00000XNursing Service ProvidersRegistered NurseGroup - Single Specialty