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Organization

OLIVE SURGICAL CARE, LLC

Active
Organization subpart
No

Provider details

NPI number
Authorized official
DENA HACKWORTH (CLINICAL DIRECTOR)
(623) 877-0900
Entity
Organization

Contact information

Practice address
8914 N 91ST AVE, SUITE 120, PEORIA, AZ 85345-8390
(623) 877-0900
(623) 298-1526
Mailing address
8914 N 91ST AVE, PEORIA, AZ 85345-8390
(623) 877-0900
(623) 298-1526

Taxonomy

Speciality
Code
Description
License number
State
261QA1903X
Ambulatory Surgical Clinic/Center
Primary

Other

Enumeration date
10/01/2012
Last updated
10/01/2012
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