# AMBULATORY SURGI-CENTER AT FMC LLC

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

## Provider details

- **NPI number:** 1154378909
- **Authorized official:** SUSAN NOVAK (DIRECTOR)
- **Authorized official phone:** (928) 214-2700

## Contact information

- **Practice address:** 1200 N BEAVER ST STE B, FLAGSTAFF, AZ 86001-3118
- **Practice address phone:** (928) 214-2700
- **Mailing address:** PO BOX 2730, FLAGSTAFF, AZ 86003-2730
- **Mailing address phone:** (928) 214-2700

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 261QA1903X | Ambulatory Surgical Clinic/Center | OSC 2303 | AZ | Yes |

## Other

- **Enumeration date:** 05/27/2006
- **Last updated:** 06/11/2010