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General NPI Number Information
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NPI Number | 1164482790
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Entity Type | Organization
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Legal Business Name | GLOBE CRNA COMPANY, LLC
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Dates
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Enumeration Date | 03/27/2006
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Last Update Date | 07/21/2022
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Provider Practice Location Address
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Address Line | 5880 S HOSPITAL DR
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City | GLOBE
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State | AZ
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Zip | 85501-9447
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Country | US
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Telephone | 928-402-1217
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Fax | 928-402-1218
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Provider Business Mailing Address
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Address Line | PO BOX 1193
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City | GLOBE
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State | AZ
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Zip | 85502-1193
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Country | US
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Telephone | 928-402-1217
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Fax | 928-402-1218
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Authorized Official
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Title or Position | PARTNER
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Name | SCOTT SHUMWAY
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Credential | CRNA
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Telephone | 928-200-5257
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 367500000X
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Taxonomy Name | Certified Registered Nurse Anesthetist
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License Number |
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License Number State | AZ
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