Provider Demographics
NPI:1386941235
Name:YUMA ENDOSCOPY SEDATION SERVICE, LLC
Entity type:Organization
Organization Name:YUMA ENDOSCOPY SEDATION SERVICE, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:DIRECTOR
Authorized Official - Prefix:
Authorized Official - First Name:MELINDA
Authorized Official - Middle Name:K
Authorized Official - Last Name:SEMLER
Authorized Official - Suffix:
Authorized Official - Credentials:RN
Authorized Official - Phone:928-343-1717
Mailing Address - Street 1:1030 W 24TH ST
Mailing Address - Street 2:SUITE I
Mailing Address - City:YUMA
Mailing Address - State:AZ
Mailing Address - Zip Code:85364-8345
Mailing Address - Country:US
Mailing Address - Phone:928-343-1717
Mailing Address - Fax:928-343-1011
Practice Address - Street 1:1030 W 24TH ST
Practice Address - Street 2:SUITE I
Practice Address - City:YUMA
Practice Address - State:AZ
Practice Address - Zip Code:85364-8345
Practice Address - Country:US
Practice Address - Phone:928-343-1717
Practice Address - Fax:928-343-1011
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2011-02-11
Last Update Date:2012-07-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AZ367500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes367500000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse Anesthetist, Certified RegisteredGroup - Single Specialty