Organization
NORTHERN ARIZONA SURGICENTER, LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MRS. NORMA BRANDON (ADMINISTRATIVE ASSISTANT)
(928) 214-2156
Entity
Organization
Contact information
Practice address
1020 N SAN FRANCISCO ST, # 100, FLAGSTAFF, AZ 86001-3281
(928) 774-3300
(928) 214-2137
Mailing address
1020 N SAN FRANCISCO ST, # 100, FLAGSTAFF, AZ 86001-3281
(928) 774-3300
(928) 214-2137
Taxonomy
Speciality
Code
Description
License number
State
261QA1903X
Ambulatory Surgical Clinic/Center
Primary
OSC-0083
AZ
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
341040
—
AZ
01
—
AZ0204550
BLUE CROSS BLUE SHIELD AZ
AZ
Enumeration date
05/31/2005
Last updated
09/24/2010
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