Provider Demographics
NPI:1851945984
Name:SURGICAL ASSISTANCE LLC
Entity type:Organization
Organization Name:SURGICAL ASSISTANCE LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:RNFA
Authorized Official - Prefix:
Authorized Official - First Name:STEVEN
Authorized Official - Middle Name:THOMAS
Authorized Official - Last Name:TARRENCE
Authorized Official - Suffix:
Authorized Official - Credentials:RNFA
Authorized Official - Phone:480-993-6057
Mailing Address - Street 1:13843 E VALLEJO ST
Mailing Address - Street 2:
Mailing Address - City:CHANDLER
Mailing Address - State:AZ
Mailing Address - Zip Code:85249-9023
Mailing Address - Country:US
Mailing Address - Phone:480-993-6057
Mailing Address - Fax:
Practice Address - Street 1:2925 E RIGGS RD STE 8-195
Practice Address - Street 2:
Practice Address - City:CHANDLER
Practice Address - State:AZ
Practice Address - Zip Code:85249-4288
Practice Address - Country:US
Practice Address - Phone:480-993-6057
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2019-07-26
Last Update Date:2019-07-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes163WR0006XNursing Service ProvidersRegistered NurseRegistered Nurse First AssistantGroup - Single Specialty