Provider Demographics
NPI:1316446636
Name:ARIZONA LITHOTRIPSY LLC
Entity type:Organization
Organization Name:ARIZONA LITHOTRIPSY LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:C. GILBERTO
Authorized Official - Middle Name:
Authorized Official - Last Name:BRITO
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:602-557-0007
Mailing Address - Street 1:77 E THOMAS RD STE 230
Mailing Address - Street 2:
Mailing Address - City:PHOENIX
Mailing Address - State:AZ
Mailing Address - Zip Code:85012-3100
Mailing Address - Country:US
Mailing Address - Phone:602-557-0007
Mailing Address - Fax:602-557-0002
Practice Address - Street 1:10301 N 92ND ST STE 101
Practice Address - Street 2:
Practice Address - City:SCOTTSDALE
Practice Address - State:AZ
Practice Address - Zip Code:85258-4506
Practice Address - Country:US
Practice Address - Phone:480-661-2662
Practice Address - Fax:480-661-9716
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2018-02-02
Last Update Date:2018-02-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes261QL0400XAmbulatory Health Care FacilitiesClinic/CenterLithotripsy
No208800000XAllopathic & Osteopathic PhysiciansUrologyGroup - Single Specialty