# GILA RIVER SURGICAL CENTER LLC

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- **Entity:** Organization
- **Status:** Active
- **Organization subpart:** No

## Provider details

- **NPI number:** 1053927210
- **Authorized official:** THOMAS MOSHIRI (MANAGER)
- **Authorized official phone:** (602) 354-5310

## Contact information

- **Practice address:** 2340 W PARKSIDE LN STE H107, PHOENIX, AZ 85027-1274
- **Practice address phone:** (602) 237-6340
- **Mailing address:** 21001 N TATUM BLVD STE 1630-606, PHOENIX, AZ 85050-4242

## Taxonomy

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

## Other

- **Enumeration date:** 09/22/2020
- **Last updated:** 02/24/2022