1225311871 NPI number — ACUTE CARE SURGICAL SPECIALISTS, LLC

Table of content: (NPI 1225311871)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1225311871 NPI number — ACUTE CARE SURGICAL SPECIALISTS, LLC

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
ACUTE CARE SURGICAL SPECIALISTS, LLC
Provider Last Name:
Provider First Name:
Provider Middle Name:
Provider Name Prefix Text:
Provider Name Suffix Text:
Provider Credential Text:
Provider Gender Code:

Provider's Other Name Information

Provider Other Organization Name:
Provider Other Organization Name Type Code:
Provider Other Last Name:
Provider Other First Name:
Provider Other Middle Name:
Provider Other Name Prefix Text:
Provider Other Name Suffix Text:
Provider Other Credential Text:
Provider Other Last Name Type Code:

NPI Number Information

NPI Number:
1225311871
Entity Type Code:
Organization
Replacement NPI:
Last Update Date:
10/02/2023
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
16601 N 40TH ST STE 204
Provider Second Line Business Mailing Address:
Provider Business Mailing Address City Name:
PHOENIX
Provider Business Mailing Address State Name:
AZ
Provider Business Mailing Address Postal Code:
85032-3356
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
602-633-3721
Provider Business Mailing Address Fax Number:
602-595-1127

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
16601 N 40TH ST STE 204
Provider Second Line Business Practice Location Address:
Provider Business Practice Location Address City Name:
PHOENIX
Provider Business Practice Location Address State Name:
AZ
Provider Business Practice Location Address Postal Code:
85032-3356
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
602-633-3721
Provider Business Practice Location Address Fax Number:
602-953-5466
Provider Enumeration Date:
09/20/2011

Additional Information

Authorized Official

Authorized Official Last Name:
SHIVELY
Authorized Official First Name:
CYNTHIA
Authorized Official Middle Name:
Authorized Official Title or Position:
CEO
Authorized Official Telephone Number:
602-996-4747

Provider Taxonomy Codes

  • Taxonomy code: 207PE0004X ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .

Other Provider's Identifiers (legacy, non-NPI)





Copyright © 2007-2025 www.npivalidator.com