Provider Demographics
NPI:1982683892
Name:TEMPE SURGICAL CENTER LTD
Entity Type:Organization
Organization Name:TEMPE SURGICAL CENTER LTD
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:MEDICAL DIRECTOR
Authorized Official - Prefix:MR
Authorized Official - First Name:RICHARD
Authorized Official - Middle Name:F
Authorized Official - Last Name:PAVESE
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:480-838-9313
Mailing Address - Street 1:2000 E SOUTHERN AVE
Mailing Address - Street 2:STE 106
Mailing Address - City:TEMPE
Mailing Address - State:AZ
Mailing Address - Zip Code:85282
Mailing Address - Country:US
Mailing Address - Phone:480-838-9313
Mailing Address - Fax:480-491-8802
Practice Address - Street 1:2000 E SOUTHERN AVE
Practice Address - Street 2:STE 106
Practice Address - City:TEMPE
Practice Address - State:AZ
Practice Address - Zip Code:85282
Practice Address - Country:US
Practice Address - Phone:480-838-9313
Practice Address - Fax:480-491-8802
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-01-10
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AZOSC0001261QA1903X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QA1903XAmbulatory Health Care FacilitiesClinic/CenterAmbulatory Surgical
Provider Identifiers
StateIdentifier IDID TypeIssuer
AZZ3C0001003Medicare ID - Type Unspecified