Provider Demographics
NPI:1013310283
Name:ORACLE SURGERY CENTER LLC
Entity type:Organization
Organization Name:ORACLE SURGERY CENTER LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:LIMOR
Authorized Official - Middle Name:PHILIPP
Authorized Official - Last Name:WALL
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:480-652-3622
Mailing Address - Street 1:5585 N ORACLE RD
Mailing Address - Street 2:
Mailing Address - City:TUCSON
Mailing Address - State:AZ
Mailing Address - Zip Code:85704-3821
Mailing Address - Country:US
Mailing Address - Phone:844-584-4260
Mailing Address - Fax:520-844-6172
Practice Address - Street 1:5585 N ORACLE RD
Practice Address - Street 2:
Practice Address - City:TUCSON
Practice Address - State:AZ
Practice Address - Zip Code:85704-3821
Practice Address - Country:US
Practice Address - Phone:844-584-4260
Practice Address - Fax:520-844-6172
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2014-10-02
Last Update Date:2016-08-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QA1903XAmbulatory Health Care FacilitiesClinic/CenterAmbulatory Surgical