Provider Demographics
NPI:1801154513
Name:ACUITY SPECIALTY HOSPITAL OF ARIZONA AT SUN CITY LLC
Entity type:Organization
Organization Name:ACUITY SPECIALTY HOSPITAL OF ARIZONA AT SUN CITY LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:SVP CFO
Authorized Official - Prefix:MR
Authorized Official - First Name:RICHARD
Authorized Official - Middle Name:L
Authorized Official - Last Name:CASSADY
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:704-887-7281
Mailing Address - Street 1:13818 N THUNDERBIRD BLVD
Mailing Address - Street 2:
Mailing Address - City:SUN CITY
Mailing Address - State:AZ
Mailing Address - Zip Code:85351-2574
Mailing Address - Country:US
Mailing Address - Phone:623-977-1325
Mailing Address - Fax:623-974-3984
Practice Address - Street 1:13818 N THUNDERBIRD BLVD
Practice Address - Street 2:
Practice Address - City:SUN CITY
Practice Address - State:AZ
Practice Address - Zip Code:85351-2574
Practice Address - Country:US
Practice Address - Phone:623-977-1325
Practice Address - Fax:623-974-3984
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2012-05-01
Last Update Date:2014-12-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes282E00000XHospitalsLong Term Care Hospital
Provider Identifiers
StateIdentifier IDID TypeIssuer
AZ032008Medicare Oscar/Certification