SCHEUBER ROAD EMERGENCY PHYSICIANS - NPI NUMBER 1851679856

Summary

Provider Name: SCHEUBER ROAD EMERGENCY PHYSICIANS

NPI Number: 1851679856

Clasification: Physician Assistant (363A00000X)

Address:
914 S SCHEUBER RD
CENTRALIA, WA
ZIP 98531

Phone Number: (360) 330-8516



Detailed Information

SCHEUBER ROAD EMERGENCY PHYSICIANS is a physician assistant in Centralia, WA. The provider is a physician assistant is a person who has successfully completed an accredited education program for physician assistant, is licensed by the state and is practicing within the scope of that license. Physician assistants are formally trained to perform many of the routine, time-consuming tasks a physician can do. In some states, they may prescribe medications. They take medical histories, perform physical exams, order lab tests and x-rays, and give inoculations. Most states require that they work under the supervision of a physician. The assigned NPI number for this provider is 1851679856 and is registered as an organization entity type and is a multi-specialty group.

The provider's business address is:

914 S SCHEUBER RD
CENTRALIA, WA
ZIP 98531-027
Phone: (360) 330-8516

The provider's authorized official is Angel L Iscovich .
The authorized official title is General Partner and has the following contact phone number (805) 563-3011.

The enumeration date for this NPI number is 7/26/2011 and was last updated on 8/18/2011.

Map - Location of Practice

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Taxonomy Codes

The following information regarding the scope of practice of this provider is available:

No. Taxonomy Code Taxonomy Clasification Taxonomy Specialization License Number License State Primary
1 363A00000X Physician Assistant No
2 363L00000X Nurse Practitioner No
3 207P00000X Emergency Medicine Yes

NPI Record

No. Field Name Field Value
1 NPI 1851679856
2 Entity Type Code 2
3 Employer Identification Number EIN
4 Provider Organization Name Legal Business Name SCHEUBER ROAD EMERGENCY PHYSICIANS
5 Provider First Line Business Practice Location Address 914 S SCHEUBER RD
6 Provider Business Practice Location Address City Name CENTRALIA
7 Provider Business Practice Location Address State Name WA
8 Provider Business Practice Location Address Postal Code 985319027
9 Provider Business Practice Location Address Country Code If outside U S US
10 Provider Business Practice Location Address Telephone Number 3603308516
11 Provider Enumeration Date 7/26/2011
12 Last Update Date 8/18/2011
13 Authorized Official Last Name ISCOVICH
14 Authorized Official First Name ANGEL
15 Authorized Official Middle Name L
16 Authorized Official Title or Position GENERAL PARTNER
17 Authorized Official Telephone Number 8055633011
18 Healthcare Provider Taxonomy Code 1 363A00000X
19 Healthcare Provider Primary Taxonomy Switch 1 N
20 Healthcare Provider Taxonomy Code 2 363L00000X
21 Healthcare Provider Primary Taxonomy Switch 2 N
22 Healthcare Provider Taxonomy Code 3 207P00000X
23 Healthcare Provider Primary Taxonomy Switch 3 Y
24 Is Organization Subpart N
25 Authorized Official Credential Text MD
26 Healthcare Provider Taxonomy Group 1 193200000X MULTI-SPECIALTY GROUP
27 Healthcare Provider Taxonomy Group 2 193200000X MULTI-SPECIALTY GROUP
28 Healthcare Provider Taxonomy Group 3 193200000X MULTI-SPECIALTY GROUP

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This page was last updated on: 10/12/2014
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