# SURGERY CENTER AT RIVER ROAD, LLC

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- **Entity:** Organization
- **Status:** Active
- **Other names:** Aesthetic Surgery at Hacienda Del Sol
- **Organization subpart:** No

## Provider details

- **NPI number:** 1801825880
- **Authorized official:** GWENDOLYN S MAXWELL M.D. (SHAREHOLDER)
- **Authorized official phone:** (520) 382-1084

## Contact information

- **Practice address:** 2490 E. RIVER ROAD, SUITE 150, TUCSON, AZ 85718-6522
- **Practice address phone:** (520) 382-1084
- **Practice address fax:** (520) 615-4572
- **Mailing address:** 2490 E. RIVER ROAD, SUITE 150, TUCSON, AZ 85718-6522
- **Mailing address phone:** (520) 382-1084
- **Mailing address fax:** (520) 615-4572

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 261QA1903X | Ambulatory Surgical Clinic/Center | 0110903 | AZ | Yes |

## Other

- **Enumeration date:** 07/01/2006
- **Last updated:** 09/22/2014