Organization
ZIVA MEDICAL AUDRAIN LLC
Active
Parent organization
ZIVA MEDICAL AUDRAIN LLC
Other names
ZIVAMED PRIMARY CARE
Organization subpart
Yes
Provider details
NPI number
Legal business name
ZIVA MEDICAL AUDRAIN LLC
Authorized official
AMANDA SHURTZ (CEO)
(573) 570-3555
Entity
Organization
Contact information
Practice address
515 E PROMENADE ST # A, MEXICO, MO 65265-2966
(573) 570-3520
(573) 675-6040
Mailing address
PO BOX 197, LAKEWOOD, NJ 08701-0197
Taxonomy
Speciality
Code
Description
License number
State
261QM1300X
Multi-Specialty Clinic/Center
Primary
—
—
363A00000X
Physician Assistant
—
—
363L00000X
Nurse Practitioner
—
—
363LF0000X
Family Nurse Practitioner
—
—
363LP2300X
Primary Care Nurse Practitioner
—
—
Other
Enumeration date
09/22/2023
Last updated
11/30/2023
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