Organization
CERTIFIED ANESTHESIA SERVICES, LTD.
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MR. JAMES C GRUBBS CRNA (VICE-PRESIDENT)
(928) 474-4923
Entity
Organization
Contact information
Practice address
807 S PONDEROSA ST, PAYSON, AZ 85541-5542
(928) 472-1367
Mailing address
PO BOX 2358, PAYSON, AZ 85547-2358
(928) 472-2311
(928) 472-9174
Taxonomy
Speciality
Code
Description
License number
State
367500000X
Certified Registered Nurse Anesthetist
Primary
RN059709
AZ
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
1639255037
NPI
AZ
01
—
18042985
WORKER'S COMP.
AZ
05
—
750423
—
AZ
05
—
750431
—
AZ
05
—
750449
—
AZ
01
—
AZ0161970
PM BLUE CROSS BLUE SHIELD
AZ
01
—
AZ0163560
WM BLUE CROSS BLUE SHIELD
AZ
01
—
AZ0480270
JG BLUE CROSS BLUE SHIELD
AZ
01
—
AZ5785
WKM HEALTHNET
AZ
01
—
AZ5790
PM HEALTHNET
AZ
01
—
AZ5877
JCG HEALTHNET
AZ
Enumeration date
10/27/2006
Last updated
05/20/2008
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