PHOENIX ENDOSCOPY LLC


Address: 349 East Coronado Road, Phoenix, AZ 85004-1525
Phone: 6022665678

PHOENIX ENDOSCOPY LLC (NPI# 1851516728) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).

Provider Overview

Nation Provider ID (NPI) 1851516728
Entity Type Organization
Organization Name PHOENIX ENDOSCOPY LLC
Practice Address 349 East Coronado Road
Phoenix
AZ 85004-1525
Mailing Address 20 Burton Hills Blvd
Suite 500
Nashville
TN 37215-6176
Practice Telephone 6022665678
Practice Fax Number 6022645646
Mailing Telephone 8152403720
Mailing Fax Number 6152341720
Enumeration Date 2007-04-16
Last Update Date 2013-04-17
Authorized Official Name MR. PHILLIP A CLENDENIN (PRESIDENT)
Authorized Official Telephone 6152403820
Is Organization Subpart N

Taxonomy

Primary Taxonomy Code Classification License Number License State Taxonomy Group
N 261QA1903X Clinic/Center
Specialization: Ambulatory Surgical
OSC3462 AZ Ambulatory Health Care Facilities
Y 261QA1903X Clinic/Center
Specialization: Ambulatory Surgical
Ambulatory Health Care Facilities

Other Provider Identifier

State Issuer Identifier Type Code
AZ BCBS IDENTIFICATION AZ0209110 01

Office Location

Street Address 349 EAST CORONADO ROAD
City PHOENIX
State AZ
Zip Code 85004-1525

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Taxonomy Information

Taxonomy Code 261QA1903X
Grouping Ambulatory Health Care Facilities
Classification Clinic/Center
Specialization Ambulatory Surgical

Taxonomy Definition

Definition to come...

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Competitor

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City PHOENIX
Zip Code 85004

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Dataset Information

Data Provider Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES)
Jurisdiction Medicare & Medicaid

This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.

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