Basic Information
| Provider Information | |||||||||
| NPI: | 1770093270 | ||||||||
| EntityType: | 2 | ||||||||
| ReplacementNPI: | |||||||||
| OrganizationName: | AZ FACILITY SERVICES | ||||||||
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| Mailing Information | |||||||||
| Address1: | 1839 S ALMA SCHOOL RD STE 354 | ||||||||
| Address2: | |||||||||
| City: | MESA | ||||||||
| State: | AZ | ||||||||
| PostalCode: | 852103028 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 4807262287 | ||||||||
| FaxNumber: | 8883169272 | ||||||||
| Practice Location | |||||||||
| Address1: | 1839 S ALMA SCHOOL RD STE 354 | ||||||||
| Address2: | |||||||||
| City: | MESA | ||||||||
| State: | AZ | ||||||||
| PostalCode: | 852103028 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 4807262287 | ||||||||
| FaxNumber: | 8883169272 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 10/10/2017 | ||||||||
| LastUpdateDate: | 09/14/2018 | ||||||||
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| AuthorizedOfficialLastName: | BOCK | ||||||||
| AuthorizedOfficialFirstName: | JOSHUA | ||||||||
| AuthorizedOfficialMiddleName: | F | ||||||||
| AuthorizedOfficialTitleorPosition: | MANAGING MEMBER | ||||||||
| AuthorizedOfficialTelephone: | 4807262287 | ||||||||
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| IsOrganizationSubpart: | N | ||||||||
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Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 261QA1903X | Y | Ambulatory Health Care Facilities | Clinic/Center | Ambulatory Surgical |
No ID Information.