HAVASU SURGERY CENTER (NPI# 1386619484) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1386619484 |
| Entity Type | Organization |
| Organization Name | HAVASU SURGERY CENTER |
| Other Organization Name | HAVASU SURGERY CENTER |
| Practice Address |
1775 Mcculloch Blvd Lake Havasu City AZ 86403 |
| Mailing Address |
103 Powell Ct Ste. 200 Brentwood TN 37027-5079 |
| Practice Telephone | 9284534200 |
| Practice Fax Number | 9284538271 |
| Mailing Telephone | 6153728500 |
| Mailing Fax Number | 6153728572 |
| Enumeration Date | 2006-02-22 |
| Last Update Date | 2020-08-22 |
| Authorized Official Name | WILLIAM M. GRACEY (COO) |
| Authorized Official Telephone | 6153728500 |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 261QA1903X |
Clinic/Center Specialization: Ambulatory Surgical |
OSC2912 | AZ | Ambulatory Health Care Facilities |
| Other Name | Type Code |
|---|---|
| Havasu Surgery Center | Doing Business As Name - Organization |
| Street Address |
1775 MCCULLOCH BLVD |
| City | LAKE HAVASU CITY |
| State | AZ |
| Zip Code | 86403 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1104479039 | Liska's Apothecary Shop, Inc. | Assisted Living Facility | 1840 Mesquite Ave., Ste. E, Lake Havasu City, AZ 86403 | 2019-07-19 |
| 1275033227 | Ayad Costy | Pharmacist | 75 North Lake Havasu City, Lake Havasu City, AZ 86403 | 2018-02-16 |
| 1942727250 | Ideal Health Care, L.L.C. | Prosthetic/Orthotic Supplier | 1675 Mesquite Ave Ste A, Lake Havasu City, AZ 86403 | 2017-08-28 |
| 1063965036 | Cerner Health Connections, Inc | Clinic/Center | 89 Civic Center Blvd, Lake Havasu City, AZ 86403 | 2016-07-26 |
| 1447643358 | Lundin Dental PC | Durable Medical Equipment & Medical Supplies | 1741 Mesquite Avenue Ste B 100, Lake Havasu City, AZ 86403 | 2015-03-17 |
| 1912301425 | Arizona Havasu Bdm Pak LLC | Dentist | 1799 North Kiowa Blvd, Unit 109, Lake Havasu, AZ 86403 | 2014-10-13 |
| 1386047850 | Emily E Vona | Nurse Practitioner | 84 Acoma Blvd N Ste 104, Lake Havasu City, AZ 86403 | 2014-09-29 |
| 1750700589 | Thomas Wennergren | Pharmacist | 25 S Lake Havasu Ave, Lake Havasu City, AZ 86403 | 2014-04-09 |
| 1285997460 | Jamie L Lemire | Pharmacist | 1980 Mcculloch Blvd, Lake Havasu City, AZ 86403 | 2012-06-21 |
| 1053694448 | Goodwill of Northern Arizona | Exclusive Provider Organization | 1990 Mcculloch Blvd North, Lake Havasu City, AZ 86403 | 2011-09-22 |
| Find all providers in zip 86403 | ||||
| Taxonomy Code | 261QA1903X |
| Grouping | Ambulatory Health Care Facilities |
| Classification | Clinic/Center |
| Specialization | Ambulatory Surgical |
| Definition to come... |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1467673293 | Havasu Regional Medical Center LLC | Clinic/Center | 1775 Mcculloch Blvd N, Lake Havasu City, AZ 86403-6549 | 2007-05-01 |
| 1174582829 | Havasu Foot & Ankle Center | Clinic/Center | 90 Riviera Dr, Lake Havasu City, AZ 86403-5716 | 2006-03-21 |
| 1497727093 | Barnet Dulaney Perkins Eye Center II Pllc | Clinic/Center | 40 Capri Blvd, Suite 102, Lake Havasu City, AZ 86403-5661 | 2006-02-07 |
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| 1134735384 | Rembrandt Treatment Center LLC | Clinic/Center | 6859 E Rembrandt Ave Ste 101, Mesa, AZ 85212-3629 | 2020-09-22 |
| 1952917445 | Aurora Surgical Center LLC | Clinic/Center | 1254 W University Ave Ste 130, Flagstaff, AZ 86001-7217 | 2020-09-20 |
| 1225641046 | Ambulatory Surgery Centers, LLC | Clinic/Center | 10825 W Mcdowell Rd Suite 110, Avondale, AZ 85392 | 2020-08-31 |
| 1780292110 | Buckeye South LLC | Clinic/Center | 23390 W Yuma Rd Ste 101, Buckeye, AZ 85326-3106 | 2020-07-22 |
| 1457976383 | Vhc-1 | Clinic/Center | 8900 E Raintree Dr Ste 100, Scottsdale, AZ 85260-7307 | 2020-06-16 |
| 1003439712 | Comprehensive Surgical Care of Sun City | Clinic/Center | 14642 N Del Webb Blvd Ste 100, Sun City, AZ 85351-2101 | 2020-05-28 |
| 1013539709 | Bsc Biltmore LLC | Clinic/Center | 2222 E Highland Ave Ste 100, Phoenix, AZ 85016-4874 | 2020-05-15 |
| Find all providers with the same taxonomy | ||||
| City | LAKE HAVASU CITY |
| Zip Code | 86403 |
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| 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.