Provider Demographics
NPI:1184078503
Name:PIMA HEART ASC LLC
Entity type:Organization
Organization Name:PIMA HEART ASC LLC
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:CEO
Authorized Official - Prefix:
Authorized Official - First Name:CLAUDIA
Authorized Official - Middle Name:
Authorized Official - Last Name:RASNAKE
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:520-838-1711
Mailing Address - Street 1:3709 N CAMPBELL AVE #201
Mailing Address - Street 2:
Mailing Address - City:TUCSON
Mailing Address - State:AZ
Mailing Address - Zip Code:85719
Mailing Address - Country:US
Mailing Address - Phone:520-320-3918
Mailing Address - Fax:520-629-9430
Practice Address - Street 1:1238 W ORANGE GROVE RD
Practice Address - Street 2:SUITE# 101
Practice Address - City:TUCSON
Practice Address - State:AZ
Practice Address - Zip Code:85704
Practice Address - Country:US
Practice Address - Phone:520-838-2300
Practice Address - Fax:520-838-2229
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2016-04-21
Last Update Date:2022-07-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AZ261QA1903X
AZOSC8295261QA1903X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QA1903XAmbulatory Health Care FacilitiesClinic/CenterAmbulatory Surgical