Provider Demographics
NPI:1497102230
Name:GLOBEMED, LLC.
Entity Type:Organization
Organization Name:GLOBEMED, LLC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:EXECUTIVE DIRECTOR
Authorized Official - Prefix:MRS
Authorized Official - First Name:DIANNA
Authorized Official - Middle Name:F
Authorized Official - Last Name:BADIPOUR
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:262-513-9999
Mailing Address - Street 1:19435 W CAPITOL DR
Mailing Address - Street 2:SUITE 103
Mailing Address - City:BROOKFIELD
Mailing Address - State:WI
Mailing Address - Zip Code:53045-2737
Mailing Address - Country:US
Mailing Address - Phone:262-513-9999
Mailing Address - Fax:262-547-4472
Practice Address - Street 1:19435 W CAPITOL DR
Practice Address - Street 2:SUITE 103
Practice Address - City:BROOKFIELD
Practice Address - State:WI
Practice Address - Zip Code:53045-2737
Practice Address - Country:US
Practice Address - Phone:262-513-9999
Practice Address - Fax:262-547-4472
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2016-05-23
Last Update Date:2016-05-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes302F00000XManaged Care OrganizationsExclusive Provider Organization