Provider Demographics
NPI:1780719419
Name:CATALINA SURGICAL FIRST ASSIST, INC
Entity type:Organization
Organization Name:CATALINA SURGICAL FIRST ASSIST, INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:MR
Authorized Official - First Name:RUSSELL
Authorized Official - Middle Name:G
Authorized Official - Last Name:WADE
Authorized Official - Suffix:
Authorized Official - Credentials:CST-CFA
Authorized Official - Phone:520-906-6112
Mailing Address - Street 1:PO BOX 32131
Mailing Address - Street 2:
Mailing Address - City:TUCSON
Mailing Address - State:AZ
Mailing Address - Zip Code:85751-2131
Mailing Address - Country:US
Mailing Address - Phone:520-906-6112
Mailing Address - Fax:
Practice Address - Street 1:7842 S CASTLE BAY ST
Practice Address - Street 2:
Practice Address - City:TUCSON
Practice Address - State:AZ
Practice Address - Zip Code:85747-9227
Practice Address - Country:US
Practice Address - Phone:520-906-6112
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-02-22
Last Update Date:2008-07-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes246ZS0410XTechnologists, Technicians & Other Technical Service ProvidersSpecialist/Technologist, OtherSurgical TechnologistGroup - Single Specialty