Cobre Valley Regional Medical Center
Organization Active NPI Community/Retail Pharmacy · Globe, AZ
NPI 1639384233 · NPPES record last updated Jul 5, 2017
Key facts
- NPI
- 1639384233
- Entity type
- Organization (NPI type 2)
- Primary specialty
- Community/Retail Pharmacy 3336C0003X
- License
- 2310 (AZ)
- Legal business name
- COBRE VALLEY REGIONAL MEDICAL CENTER
- Practice address
- 5880 S Hospital Dr
Globe, AZ 85501-9447 - Phone
- (928) 425-3261
- Fax
- (928) 425-1193
- NPI assigned
- May 14, 2007
- Organization subpart
- No
Authorized official
- Name
- Mr. Neal D. Jensen
- Title
- Ceo
- Phone
- (928) 425-3261
Owners & managing parties with NPI records 2
-
Alan K. Osumi, MD
Other NPIs on the same Medicare enrollment 10
Corporate family (same tax ID) 12
Related certifications (CCN) 9
Practitioners 58
-
Rachel Alt, MD
-
Cyrus C Bowers, D.O.
-
Ryan Bradley, PA-C
-
Robin Broz, D.O.
-
Douglas J Campbell, M.D.
-
Tanner Bo Carlson, PA-C
-
Scott T. Croft, M.D.
-
Fernando Cruzado, MD
-
Nicholas Elkins, D.O.
-
Mark Ellis, DPM
-
Margo Ruth Flores, NP-C
-
Evan Franke, M.D.
-
Karen M Gremminger, M.D.
-
Blaine S. Jensen, PA-C
-
Einstein Juma, M.D., MLS
-
Douglas J Krell, MD
Affiliated clinicians 154
-
Joseph G Abdo, M.D.
-
Khalid Gamal Aboul-Nasr, M.D.
-
Rachel Alt, MD
-
Shiv Bagga, MD
-
Mark Bailey, MD
-
James R Bardwell, D.O.
-
Sara Kay Bennett, DNP, RNP, FNP
-
Scott D Bingham, DO
-
Cyrus C Bowers, D.O.
-
Ashley Bravo, NP
-
Mars Brimhall, CRNA
-
Chad Michael Campbell, PA-C
-
Douglas J Campbell, M.D.
-
Carlos Luis Cantu, M.D.
-
Tanner Bo Carlson, PA-C
-
Julius Ray Charlie, M.D.
-
Michelle Anne Craft, APRN-RNP, FNP-BC
-
Scott T. Croft, M.D.
-
Fernando Cruzado, MD
-
Antonio Davila, M.D.
Medicare Care Compare: Hospital
- Listed as
- Cobre Valley Regional Medical Center
- Overall star rating
- ★★☆☆☆ 2 of 5
- Type
- Critical Access Hospitals
- Ownership
- Voluntary non-profit - Private
- Medicare certification status
- Active
- Emergency services
- Yes
Medicare participation
- Medicare fee-for-service enrollment
- Enrolled (2 enrollments) in AZ
Hospital certification: CCN 031314
- Legal name
- COBRE VALLEY REGIONAL MEDICAL CENTER
- Certification status
- Active
- Provider type (POS)
- Hospital – Critical access hospital
- Participating since
- Dec 5, 2006
- Last certification
- Mar 6, 2025
- Beds
- 25
- Ownership / control type
- Private (not for profit)
- Organization structure
- Corporation · Non-profit
- Incorporated
- Mar 29, 1988 in AZ
- Enrollment address
- 5880 S Hospital Dr
Globe, AZ 85501-9447
All disclosed owners & managing parties 12
| Name | Role | Since | Share |
|---|---|---|---|
| Jack Bradford |
Corporate Director |
Jun 23, 2022 | |
| Jody Daggett |
Corporate Director |
Jan 20, 2016 | |
| Edward Carpenter |
Corporate Director |
Oct 24, 2008 | |
| Nick Renon |
Corporate Director |
Jul 28, 2025 | |
| Paula Horn |
Corporate Director |
Feb 22, 2024 | |
| Neal Duane Jensen |
Corporate Officer |
Jul 10, 1998 | |
| Alan Osumi |
Corporate Director |
Mar 1, 2015 | |
| Robert E Hollis |
Corporate Director |
Jul 20, 2014 | |
| Jendean G Sartain |
Corporate Director |
Mar 1, 2005 | |
| Frank Stapleton |
W-2 Managing Employee | Jan 25, 2002 | |
| Fernando Shipley |
Corporate Director |
Aug 1, 2004 | |
| Judy Bessee |
Corporate Director |
Feb 10, 2017 |
Medicare enrollment records
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| O20040312001228 | AZ | Part B Supplier - Clinic/Group Practice | 0648181693 |
Receives reassigned benefits from 69 practitioners 9 other NPIs on this enrollment This NPI is an additional NPI on the enrollment Practice locations: Young, AZ; Tonto Basin, AZ; Kearny, AZ; Globe, AZ; Superior, AZ |
| O20081006000059 | AZ | Part a Provider - Critical Access Hospital | 0648181693 |
Receives reassigned benefits from 51 practitioners 2 other NPIs on this enrollment This NPI is an additional NPI on the enrollment Practice locations: Globe, AZ |
National Provider Directory
- Tax ID family
- Cobre Valley Community Hospital
Locations
14 N Magma Ave
Superior, AZ 85173
Phone (520) 689-2423
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Community/Retail Pharmacy | 3336C0003X | 2310 | AZ | Yes |
Addresses
Primary practice location
5880 S Hospital Dr
Globe, AZ 85501-9447
Mailing address
5880 S Hospital Dr
Globe, AZ 85501-9447
Phone (928) 425-3261
Other identifiers
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1639384233 | Other | AZ | NPI |
| 0322583 | Other | AZ | NCPDP PROVIDER ID |
Other providers in Globe, AZ
- Cobre Valley Internal Medicine, PLLC.
- Cobre Valley Regional Medical Center
- Cobre Valley Regional Medical Center
- Cobre Valley Regional Medical Center
- Cobre Valley Regional Medical Center
- Cobre Valley Regional Medical Center
- Cobre Valley Regional Medical Center
- Cobre Valley Regional Medical Center
- Cobre Valley Regional Medical Center
- Community Bridges, Inc
All providers in Globe, AZ · Community/Retail Pharmacy in Arizona
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Jul 5, 2017. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- Medicare Fee-For-Service Public Provider Enrollment (CMS/PECOS): enrollments, PAC IDs and benefit reassignments.
- CMS facility enrollments, All Owners and change-of-ownership files: CCNs, owners and managing parties.
- Provider of Services files (CMS): certification status, beds and related CCNs.
- Medicare Care Compare provider data (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.