# DHEW IND HLTH SV HLTH SVS & MNTL HLTH ADM

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- **Entity:** Organization
- **Status:** Active
- **Parent organization:** PHOENIX INDIAN MEDICAL CENTER
- **Other names:** PIMC - Ambulatory Surgical Center
- **Organization subpart:** Yes

## Provider details

- **NPI number:** 1003083551
- **Legal business name:** PHOENIX INDIAN MEDICAL CENTER
- **Authorized official:** MISS LAURA A TILLMAN MD (CMO)
- **Authorized official phone:** (602) 263-1674

## Contact information

- **Practice address:** 4212 NORTH 16TH STREET, PHOENIX INDIAN MEDICAL CENTER AMBULATORY SURGICAL CENT, PHOENIX, AZ 85016-5319
- **Practice address phone:** (602) 263-1200
- **Practice address fax:** (602) 263-1618
- **Mailing address:** PIMC ASC POBOX 95460, CLEVELAND, OH 44193-0001
- **Mailing address phone:** (602) 581-6088
- **Mailing address fax:** (602) 263-1619

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 261QA1903X | Ambulatory Surgical Clinic/Center | — | NULL | Yes |

## Other

- **Enumeration date:** 05/14/2008
- **Last updated:** 05/26/2021