# ELITE VASCULAR, VEIN, AND SURGICAL SPECIALISTS, LLC

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

## Provider details

- **NPI number:** 1952703449
- **Authorized official:** SKY MOORE DC (MANAGER/OWNER)
- **Authorized official phone:** (602) 354-5659

## Contact information

- **Practice address:** 10255 N 32ND ST, PHOENIX, AZ 85028-3851
- **Practice address phone:** (602) 354-5659
- **Practice address fax:** (602) 795-9948
- **Mailing address:** 2813 E CAMELBACK RD, SUITE 430, PHOENIX, AZ 85016-4325
- **Mailing address phone:** (602) 354-5659
- **Mailing address fax:** (602) 795-9949

## Taxonomy

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

## Other

- **Enumeration date:** 09/16/2014
- **Last updated:** 09/16/2014