Arizona Em-I Medical Services
Organization Active NPI Nurse Practitioner · Douglas, AZ
NPI 1891070520 · NPPES record last updated Oct 13, 2011
Key facts
- NPI
- 1891070520
- Entity type
- Organization (NPI type 2)
- Primary specialty
- Nurse Practitioner 363L00000X
- Legal business name
- ARIZONA EM-I MEDICAL SERVICES
- Practice address
- 2174 W Oak Ave
Douglas, AZ 85607-6003 - Phone
- (520) 364-7931
- NPI assigned
- Oct 13, 2011
- Organization subpart
- No
Authorized official
- Name
- Donald T Godbold, M.D.
- Title
- President
- Phone
- (800) 444-7009
Other NPIs on the same Medicare enrollment 5
Member organizations 8
Medicare participation
- Medicare fee-for-service enrollment
- Enrolled in AZ
Medicare enrollment records
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| O20040421000835 | AZ | Part B Supplier - Clinic/Group Practice | 8325034812 |
Receives reassigned benefits from 53 practitioners 5 other NPIs on this enrollment This NPI is an additional NPI on the enrollment Practice locations: Yuma, AZ |
National Provider Directory
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Nurse Practitioner |
363L00000X | Yes |
Addresses
Primary practice location
2174 W Oak Ave
Douglas, AZ 85607-6003
Mailing address
815 S Palafox St
Suite 300
Pensacola, FL 32502-5960
Phone (800) 444-7009
Other providers in Douglas, AZ
- Mohamed Bourahi Alsoubaii
- Heidy H Anway
- Ciara Jane Aparicio
- Arizona Ambulance of Douglas, Inc.
- Arizona Caring Social Services, L.L.C.
- Arizona Family Care Associates, Inc
- Nicole Marie Baldenegro
- Gino Jose Bardi Lola
- Shirley L. Bayham-Hicks
- Karina Celeste Bechtold
All providers in Douglas, AZ · Nurse Practitioner in Arizona
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Oct 13, 2011. 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.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.