Organization
SURPRISE FACILITY GROUP, LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MELISSA SHIELDS (PROGRAM DIRECTOR)
(602) 714-8185
Entity
Organization
Contact information
Practice address
16960 W BELL RD STE 502, SURPRISE, AZ 85374-8946
(602) 714-8185
Mailing address
3724 N 3RD ST STE 301, PHOENIX, AZ 85012-2035
(602) 714-8185
(602) 714-8117
Taxonomy
Speciality
Code
Description
License number
State
261QA1903X
Ambulatory Surgical Clinic/Center
Primary
—
—
Other
Enumeration date
04/02/2018
Last updated
04/02/2018
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