Organization
PHOENIX ORTHOPAEDIC AMBULATORY CENTER, LLC
Active
Other names
Gateway Surgery Center
Organization subpart
No
Provider details
NPI number
Authorized official
MR. JEFFREY SNODGRASS (PRESIDENT)
(615) 665-1283
Entity
Organization
Contact information
Practice address
690 N COFCO CENTER CT, SUITE 150, PHOENIX, AZ 85008-6462
(602) 288-4441
(602) 288-4480
Mailing address
690 N COFCO CENTER CT, SUITE 150, PHOENIX, AZ 85008-6462
(602) 288-4441
(602) 288-4480
Taxonomy
Speciality
Code
Description
License number
State
261QA1903X
Ambulatory Surgical Clinic/Center
Primary
OSC3177
AZ
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
AZ0208190
BCBS OF ARIZONA
AZ
Enumeration date
08/17/2005
Last updated
04/27/2021
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