# PRESCOTT OUTPATIENT SURGICAL CENTER LLC

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

## Provider details

- **NPI number:** 1083624670
- **Authorized official:** MR. ERIC BOON (OFFICER/AUTHORIZED OFFICIAL)
- **Authorized official phone:** (480) 567-0269

## Contact information

- **Practice address:** 815 AINSWORTH DR, PRESCOTT, AZ 86301-1631
- **Practice address phone:** (928) 778-9770
- **Practice address fax:** (928) 778-9028
- **Mailing address:** 815 AINSWORTH DR, PRESCOTT, AZ 86301-1631
- **Mailing address phone:** (928) 778-9770
- **Mailing address fax:** (928) 778-9028

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 261QA1903X | Ambulatory Surgical Clinic/Center | OSC0035 | AZ | Yes |

## Other

- **Enumeration date:** 08/08/2006
- **Last updated:** 09/05/2024