Organization
SUNRISE AMBULATORY SURGICAL CENTER LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MR. JEFFREY SNODGRASS (PRESIDENT)
(615) 665-1283
Entity
Organization
Contact information
Practice address
5448 WHITE MOUNTAIN BLVD STE 100, LAKESIDE, AZ 85929-5736
(928) 532-3010
(928) 532-1161
Mailing address
1A BURTON HILLS BLVD, NASHVILLE, TN 37215-6187
(615) 240-3820
(615) 234-1720
Taxonomy
Speciality
Code
Description
License number
State
261QA1903X
Ambulatory Surgical Clinic/Center
Primary
OSC2943
AZ
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
643371
—
AZ
Enumeration date
01/31/2006
Last updated
03/29/2021
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