Basic Information
| Provider Information | |||||||||
| NPI: | 1467169474 | ||||||||
| EntityType: | 2 | ||||||||
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| OrganizationName: | BOR SURGICAL FIRST ASSIST PLLC | ||||||||
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| Mailing Information | |||||||||
| Address1: | 10582 E RALPH ALVAREZ PL | ||||||||
| Address2: | |||||||||
| City: | TUCSON | ||||||||
| State: | AZ | ||||||||
| PostalCode: | 857475885 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 5204442753 | ||||||||
| FaxNumber: | 5202962738 | ||||||||
| Practice Location | |||||||||
| Address1: | 5301 E GRANT RD | ||||||||
| Address2: | |||||||||
| City: | TUCSON | ||||||||
| State: | AZ | ||||||||
| PostalCode: | 857122805 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 5203275461 | ||||||||
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| Other Information | |||||||||
| ProviderEnumerationDate: | 10/31/2022 | ||||||||
| LastUpdateDate: | 10/31/2022 | ||||||||
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| AuthorizedOfficialLastName: | ORTEGA-RUTHERFORD | ||||||||
| AuthorizedOfficialFirstName: | BARBARA | ||||||||
| AuthorizedOfficialMiddleName: | M | ||||||||
| AuthorizedOfficialTitleorPosition: | RNFA | ||||||||
| AuthorizedOfficialTelephone: | 5204442753 | ||||||||
| IsSoleProprietor: | |||||||||
| IsOrganizationSubpart: | Y | ||||||||
| ParentOrganizationLBN: | BOR SURGICAL FIRST ASSIST PLLC | ||||||||
| AuthorizedOfficialNamePrefix: | MRS. | ||||||||
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| AuthorizedOfficialCredential: | BSN, RN, CNOR, RNFA | ||||||||
| NPICertificationDate: | 10/30/2022 | ||||||||
Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 282N00000X | Y | Hospitals | General Acute Care Hospital |
No ID Information.