Provider Demographics
NPI:1992393912
Name:HORIZON RIDGE SURGERY CENTER LLC
Entity Type:Organization
Organization Name:HORIZON RIDGE SURGERY CENTER LLC
Other - Org Name:HORIZON RIDGE SURGERY CENTER
Other - Org Type:Doing Business As
Authorized Official - Title/Position:OFFICER/AUTHORIZED OFFICIAL
Authorized Official - Prefix:
Authorized Official - First Name:ERIC
Authorized Official - Middle Name:
Authorized Official - Last Name:BOON
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:480-567-0269
Mailing Address - Street 1:10561 JEFFREYS ST STE 130
Mailing Address - Street 2:
Mailing Address - City:HENDERSON
Mailing Address - State:NV
Mailing Address - Zip Code:89052-4267
Mailing Address - Country:US
Mailing Address - Phone:702-724-8900
Mailing Address - Fax:702-982-8854
Practice Address - Street 1:10561 JEFFREYS ST STE 130
Practice Address - Street 2:
Practice Address - City:HENDERSON
Practice Address - State:NV
Practice Address - Zip Code:89052-4267
Practice Address - Country:US
Practice Address - Phone:702-724-8900
Practice Address - Fax:702-982-8854
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2021-01-05
Last Update Date:2021-06-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QA1903XAmbulatory Health Care FacilitiesClinic/CenterAmbulatory Surgical