CHANDLER ENDOSCOPY AMBULATORY SURGERY CENTER, LLC
Ambulatory Health at Pecos Rd, Chandler, AZ

License number
Arizona OSC514
Category
Ambulatory Health
Type
Ambulatory Surgical
Owner
Name: JENETHA D MORAN
Title: AUTHORIZED OFFICIAL
Phone: (972) 763-3893
Address
Address
2095 W Pecos Rd SUITE 1, Chandler, AZ 85224
National Provider ID: 1093086183
LicenseFiles verified this license of Nov 7, 2017 at the National Plan and Provider Enumeration System.

Organization information

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CHANDLER ENDOSCOPY AMBULATORY SURGERY CENTER, LLC

Chandler, AZ  -  Addison, TX

Registration:
Jan 17, 2012
Addresses:
600 S Dobson Rd BLDG A, Chandler, AZ 85224 (Physical)
15305 Dallas Pkwy #1600, Addison, TX 75001 (Physical)
State ID:
L-1732882-4
Expiration:
PERPETUAL
Members:
Michael Bass (Manager), 15305 Dallas Pkwy #1600, Addison, TX 75001 (Physical),Dignity/Usp Phoenix Surgery Ce (Member), 15305 Dallas Pkwy #1600, Addison, TX 75001 (Physical),East Valley Gastroenterology A (Member), 600 S Dobson Rd BLDG A, Chandler, AZ 85224 (Physical)
Agent:
Ct Corporation System,2390 E Camelback Rd, Phoenix, AZ 85016 (Physical)

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