LAKESHORE UNITED LLC; NPI #1902446495

Contact Information

LAKESHORE UNITED LLC

4765 S LAKESHORE DR
TEMPE, AZ 85282-7197

Phone: 480-646-3258
Fax:
Website:

Specialty	Taxonomy Code	Specialty Code	Provider Type
Ambulatory Surgical	261QA1903X	49	Ambulatory Surgical Center
Pain	261QP3300X
Surgery	208600000X	02	Physician/General Surgery

Indicates primary specialty

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NPI Profile & details for LAKESHORE UNITED LLC

NPI #	`1902446495`
LBN Legal business name	LAKESHORE UNITED LLC
Authorized official	JEREMY BUCKNER - (SOLE MEMBER)
Entity	Organization
Organization subpart ¹	No
Enumeration date	01/13/2020
Last updated	01/13/2020 - About 6 years ago
Identifiers	n/a

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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