Organization
AKDHC SURGERY CENTER, LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MS. ADONIS ESCOBEDO (CREDENTIALING MANAGER)
(602) 759-6883
Entity
Organization
Contact information
Practice address
3600 W TANGERINE RD, SUITE 100, MARANA, AZ 85658
(520) 547-2468
(520) 547-2471
Mailing address
6622 N 91ST AVE STE 220, GLENDALE, AZ 85305-2569
(602) 759-6883
(602) 224-3358
Taxonomy
Speciality
Code
Description
License number
State
261QA1903X
Ambulatory Surgical Clinic/Center
Primary
—
AZ
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
244929
—
AZ
Enumeration date
07/02/2018
Last updated
08/10/2018
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