Provider Demographics
NPI:1285762872
Name:ARENA AND MONACO, PSC CRNA
Entity type:Organization
Organization Name:ARENA AND MONACO, PSC CRNA
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:GREGG
Authorized Official - Middle Name:K
Authorized Official - Last Name:ARENA
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:606-523-2140
Mailing Address - Street 1:2 TRILLIUM WAY STE 205
Mailing Address - Street 2:
Mailing Address - City:CORBIN
Mailing Address - State:KY
Mailing Address - Zip Code:40701-8445
Mailing Address - Country:US
Mailing Address - Phone:606-523-2140
Mailing Address - Fax:606-523-2547
Practice Address - Street 1:1 TRILLIUM WAY
Practice Address - Street 2:
Practice Address - City:CORBIN
Practice Address - State:KY
Practice Address - Zip Code:40701-8426
Practice Address - Country:US
Practice Address - Phone:606-528-1212
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-03-02
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes367500000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse Anesthetist, Certified RegisteredGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
KY74903493Medicaid