Olive Surgical Care, LLC

Primary specialty

Ambulatory Surgical Clinic/CenterTaxonomy code 261QA1903X

Legal business name

OLIVE SURGICAL CARE, LLC

Practice address

8914 N 91St Ave
Suite 120
Peoria, AZ 85345-8390

Phone

(623) 877-0900

Fax

(623) 298-1526

NPI assigned

Oct 1, 2012

Organization subpart

No

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name

Dena Hackworth

Title

Clinical Director

Phone

(623) 877-0900

Specialties & licenses 1

Addresses

Tax ID family

Desert Vista Surgery Center LLC2 organizations share this tax ID, including this one

Other organizations with this tax ID 1

Organizations that report the same tax identification number in the National Provider Directory.

• Olive Surgical Care, LLC

  dba Desert Vista Surgery Center, LLC

  • Ambulatory Surgical Clinic/Center
  • Peoria, AZ
  • NPI 1942624622
  NPD tax ID

Locations

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1349049600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1349049600000",
    "number": "1700137650",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "8914 N 91ST AVE",
            "city": "PEORIA",
            "state": "AZ",
            "postal_code": "853458390",
            "telephone_number": "623-877-0900",
            "fax_number": "623-298-1526"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "8914 N 91ST AVE",
            "address_2": "SUITE 120",
            "city": "PEORIA",
            "state": "AZ",
            "postal_code": "853458390",
            "telephone_number": "623-877-0900",
            "fax_number": "623-298-1526"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "OLIVE SURGICAL CARE, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2012-10-01",
        "last_updated": "2012-10-01",
        "status": "A",
        "authorized_official_last_name": "HACKWORTH",
        "authorized_official_first_name": "DENA",
        "authorized_official_title_or_position": "CLINICAL DIRECTOR",
        "authorized_official_telephone_number": "623-877-0900"
    },
    "taxonomies": [
        {
            "code": "261QA1903X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Ambulatory Surgical",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Theresa Ojoye
• Matthew Okane, PA-C
• Queen Okoronkwo
• Anna Louise Olavarria
• Gerald L Oldham, MD
• Olive Surgical Care, LLC (Desert Vista Surgery Center, LLC)
• Allison Olshove
• Breanna Rose Olson, RDH
• Dennis Palmer Olson, DDS
• Lisa Olson, PT, DPT

• Ambulatory Surgical Clinic/Center in Peoria, AZ
• Providers in Peoria, AZ by specialty
• Ambulatory Surgical Clinic/Center in Arizona

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 1, 2012; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.