National Provider Identifier Database

59TH AVENUE SURGICAL FACILITY LTD
Ambulatory Surgical


Contact Information

59TH AVENUE SURGICAL FACILITY, LTD
8608 N 59TH AVE
GLENDALE, AZ85302-5404
Phone: 623-934-3211
Fax: 623-930-1891
Website:
Specialty Taxonomy Code
* Ambulatory Surgical 261QA1903X

* Indicates primary specialty

NPI Profile & details for 59TH AVENUE SURGICAL FACILITY, LTD

NPI Number 1508089624
Legal business name
LBN
59TH AVENUE SURGICAL FACILITY, LTD
Authorized official MARK GORMAN - (C.E.O.)
Entity Organization
Organization subpart No
Enumeration date 04/10/2007
Last updated 08/22/2020 - About 6 years ago
Sole proprietor1 Not specified
Identifiers n/a

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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