National Provider Identifier Database

AMBULATORY SURGI CENTER AT FMC LLC
Ambulatory Surgical


Contact Information

AMBULATORY SURGI-CENTER AT FMC LLC
1200 N BEAVER ST STE B
FLAGSTAFF, AZ86001-3118
Phone: 928-214-2700
Fax:
Website:
Specialty Taxonomy Code
* Ambulatory Surgical 261QA1903X

* Indicates primary specialty

NPI Profile & details for AMBULATORY SURGI-CENTER AT FMC LLC

NPI Number 1154378909
Legal business name
LBN
AMBULATORY SURGI-CENTER AT FMC LLC
Authorized official SUSAN NOVAK - (DIRECTOR)
Entity Organization
Organization subpart No
Enumeration date 05/27/2006
Last updated 06/11/2010 - About 16 years ago
Sole proprietor1 Not specified
Identifiers
  • AZ License #: OSC 2303
  • AZ Medicaid: 478364
  • AZ Other: AZ0205860 BCBS/AZ
  • AZ Other: 1Z7274 HEALTHNET
  • AZ Other: 157543 UHC

1 A sole proprietor/sole proprietorship is an individual, and as such, is eligible for a single NPI number. The sole proprietor must apply for the NPI number using his or her own Social Security Number (SSN), not an Employer Identification Number (EIN) even if he/she has an EIN.

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