Provider Demographics
NPI:1780415356
Name:GREATER PHX ASC LLC
Entity type:Organization
Organization Name:GREATER PHX ASC LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:COO
Authorized Official - Prefix:MR
Authorized Official - First Name:RYAN
Authorized Official - Middle Name:C
Authorized Official - Last Name:STRAND
Authorized Official - Suffix:
Authorized Official - Credentials:COO
Authorized Official - Phone:480-245-7600
Mailing Address - Street 1:3333 E CAMELBACK RD STE 140
Mailing Address - Street 2:
Mailing Address - City:PHOENIX
Mailing Address - State:AZ
Mailing Address - Zip Code:85018-2387
Mailing Address - Country:US
Mailing Address - Phone:480-245-7600
Mailing Address - Fax:
Practice Address - Street 1:3333 E CAMELBACK RD STE 140
Practice Address - Street 2:
Practice Address - City:PHOENIX
Practice Address - State:AZ
Practice Address - Zip Code:85018-2387
Practice Address - Country:US
Practice Address - Phone:480-245-7600
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2024-08-13
Last Update Date:2025-03-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes261QA1903XAmbulatory Health Care FacilitiesClinic/CenterAmbulatory SurgicalGroup - Single Specialty