Organization
DHEW IND HLTH SV HLTH SVS & MNTL HLTH ADM
Active
Parent organization
PHOENIX INDIAN MEDICAL CENTER
Other names
PIMC - Ambulatory Surgical Center
Organization subpart
Yes
Provider details
NPI number
Legal business name
PHOENIX INDIAN MEDICAL CENTER
Authorized official
MISS LAURA A TILLMAN MD (CMO)
(602) 263-1674
Entity
Organization
Contact information
Practice address
4212 NORTH 16TH STREET, PHOENIX INDIAN MEDICAL CENTER AMBULATORY SURGICAL CENT, PHOENIX, AZ 85016-5319
(602) 263-1200
(602) 263-1618
Mailing address
PIMC ASC POBOX 95460, CLEVELAND, OH 44193-0001
(602) 581-6088
(602) 263-1619
Taxonomy
Speciality
Code
Description
License number
State
261QA1903X
Ambulatory Surgical Clinic/Center
Primary
—
—
Other
Enumeration date
05/14/2008
Last updated
05/26/2021
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