Organization
SURGERY CENTER OF PEORIA, LLC
Active
Other names
Surgery Center of Peoria
Organization subpart
No
Provider details
NPI number
Authorized official
ERIC BOON (OFFICER/AUTHORIZED OFFICIAL)
(480) 567-0269
Entity
Organization
Contact information
Practice address
13260 N 94TH DR, SUITE 200, PEORIA, AZ 85381-4828
(623) 933-2900
(623) 933-0017
Mailing address
13260 N 94TH DR, SUITE 200, PEORIA, AZ 85381-4828
(623) 933-2900
(623) 933-0017
Taxonomy
Speciality
Code
Description
License number
State
261QA1903X
Ambulatory Surgical Clinic/Center
Primary
OSC0016
AZ
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
436883
—
AZ
01
—
490003885
RAILROAD MEDICARE
AZ
Enumeration date
08/02/2005
Last updated
09/22/2025
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