MEDICARE: STAT MOBILE IV

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	163WI0500X	Infusion Therapy Registered Nurse

General Provider Information

NPI Number	:	1609739168
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	STAT MOBILE IV

Provider Business Mailing Address
First Line	:	11056 W PANTHER PEAK DR
Second Line	:
City	:	TUCSON
State	:	AZ
Zip	:	85743-8672
Country	:	US
Telephone Number	:	520-306-9300
Fax Number	:

Provider Business Practice Location Address
First Line	:	11056 W PANTHER PEAK DR
Second Line	:
City	:	TUCSON
State	:	AZ
Zip	:	85743-8672
Country	:	US
Telephone Number	:	520-306-9300
Fax Number	:

Authorized Official
Title or Position	:	CNO
Name	:	CALAN MURPHY
Credential	:	RN
Telephone Number	:	520-306-9300

Provider Enumeration Date	:	12/03/2025
Last Update Date	:	12/03/2025

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