| Thomas Scruggs, CRNA | |
|
1930 W Broadway St Ste A, Missoula, MT 59808-1960 | |
| (406) 541-6844 | |
| (406) 541-6843 |
| Full Name | Thomas Scruggs |
|---|---|
| Gender | Male |
| Speciality | Nurse Anesthetist, Certified Registered |
| Location | 1930 W Broadway St Ste A, Missoula, Montana |
| Accepts Medicare Assignments | Medicare enrolled and may accept medicare through third-party reassignment. May prescribe medicare part D drugs. |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1003847104 | NPI | - | NPPES |
| 805979900 | Medicaid | ID |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 367500000X | Nurse Anesthetist, Certified Registered | 101158 (Montana) | Primary |
| 367500000X | Nurse Anesthetist, Certified Registered | N-30039 (Idaho) | Secondary |
| Entity Name | Northern Montana Hospital |
|---|---|
| Entity Type | Part B Supplier - Clinic/group Practice |
| Entity Identifiers | NPI Number: 1427059070 PECOS PAC ID: 2264343912 Enrollment ID: O20031229000278 |
| Entity Name | Cmsc Llc |
|---|---|
| Entity Type | Part B Supplier - Clinic/group Practice |
| Entity Identifiers | NPI Number: 1639109978 PECOS PAC ID: 5890602494 Enrollment ID: O20130502000527 |
| Entity Name | Montana Gastroenterology, Pllc |
|---|---|
| Entity Type | Part B Supplier - Clinic/group Practice |
| Entity Identifiers | NPI Number: 1821612946 PECOS PAC ID: 7618396318 Enrollment ID: O20200930000358 |
| Entity Name | Northstar Anesthesia Of Montana |
|---|---|
| Entity Type | Part B Supplier - Clinic/group Practice |
| Entity Identifiers | NPI Number: 1265059869 PECOS PAC ID: 5395151294 Enrollment ID: O20210301001196 |
| Mailing Address | Practice Location Address |
|---|---|
| Thomas Scruggs, CRNA 1930 W Broadway St Ste A, Missoula, MT 59808-1960 Ph: (406) 541-6844 | Thomas Scruggs, CRNA 1930 W Broadway St Ste A, Missoula, MT 59808-1960 Ph: (406) 541-6844 |
Edward Michael Mondloch, CRNA Nurse Anesthetist - CR Medicare: Not Enrolled in Medicare Practice Location: 700 W Kent Ave, Missoula, MT 59801 Phone: 406-728-3501 | |
Tana M Taylor, CRNA Nurse Anesthetist - CR Medicare: Accepting Medicare Assignments Practice Location: 1930 W Broadway St Ste A, Missoula, MT 59808 Phone: 406-541-6844 Fax: 406-541-6843 | |
Stephen Hugh Abercrombie, CRNA Nurse Anesthetist - CR Medicare: Accepting Medicare Assignments Practice Location: 1930 W Broadway St Ste A, Missoula, MT 59808 Phone: 406-541-6844 Fax: 406-541-6843 |