MESA AZ ENDOSCOPY ASC LLC; NPI #1770557233

Contact Information

MESA AZ ENDOSCOPY ASC LLC

603 W BASELINE RD STE 101
MESA, AZ 85210-6050

Phone: 480-969-0405
Fax: 480-969-2280
Website:

	Specialty	Taxonomy Code	Specialty Code	Provider Type
	Ambulatory Surgical	261QA1903X	49	Ambulatory Surgical Center

Indicates primary specialty

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NPI Profile & details for MESA AZ ENDOSCOPY ASC LLC

NPI Number 1770557233

LBN Legal business name MESA AZ ENDOSCOPY ASC LLC

Authorized official SAMANTHA DILLON - (ADMINISTRATOR)

Entity Organization

Organization subpart ¹ No

Enumeration date 02/13/2006

Last updated 10/15/2021 - About 5 years ago

Identifiers

AZ	License #	OSC3651
AZ	Other	860929359	TRI WEST - TRICARE

¹ Some organization health care providers are made up of components that furnish different types of health care or have separate physical locations where health care is furnished. These components and physical locations are not themselves legal entities, but are part of the organization health care provider (which is a legal entity). A covered organization provider may decide that its subparts (if it has any) should have their own NPI numbers. If a subpart conducts any HIPAA standard transactions on its own (e.g., separately from its parent), it must obtain its own NPI number.

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