Organization
HAVASU REGIONAL MEDICAL CENTER LLC
Active
Parent organization
HAVASU REGIONAL MEDICAL CENTER LLC
Other names
Havasu Surgery Center
Organization subpart
Yes
Provider details
NPI number
Legal business name
HAVASU REGIONAL MEDICAL CENTER LLC
Authorized official
KATHY J. TEAGUE (SECRETARY)
(615) 920-7000
Entity
Organization
Contact information
Practice address
1775 MCCULLOCH BLVD N, LAKE HAVASU CITY, AZ 86403-6549
(928) 855-8185
Mailing address
330 SEVEN SPRINGS WAY, BRENTWOOD, TN 37027-4536
(615) 920-7000
(615) 920-8913
Taxonomy
Speciality
Code
Description
License number
State
261QA1903X
Ambulatory Surgical Clinic/Center
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
231644
—
AZ
Enumeration date
05/01/2007
Last updated
07/26/2019
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