Organization
CARONDELET ST. MARY'S NORTHWEST, LLC
Active
Other names
Carondelet Foothills Surgery Center
Organization subpart
No
Provider details
NPI number
Authorized official
JENETHA D MORAN (OFFICER / AUTHORIZED OFFICIAL)
(972) 763-3893
Entity
Organization
Contact information
Practice address
2220 W ORANGE GROVE RD, TUCSON, AZ 85741-3117
(520) 877-5660
(520) 877-5669
Mailing address
2220 W ORANGE GROVE RD, TUCSON, AZ 85741-3117
(520) 877-5660
(520) 877-5669
Taxonomy
Speciality
Code
Description
License number
State
261QA1903X
Ambulatory Surgical Clinic/Center
Primary
OSC3857
AZ
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
006486
—
AZ
01
—
03C0001289
CCN
AZ
Enumeration date
12/14/2006
Last updated
01/20/2017
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