1013164748 NPI number — QUALITY ANESTHESIA PAIN SERVICES, PLLC

Table of content: (NPI 1013164748)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1013164748 NPI number — QUALITY ANESTHESIA PAIN SERVICES, PLLC

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
QUALITY ANESTHESIA PAIN SERVICES, PLLC
Provider Last Name:
Provider First Name:
Provider Middle Name:
Provider Name Prefix Text:
Provider Name Suffix Text:
Provider Credential Text:
Provider Gender Code:

Provider's Other Name Information

Provider Other Organization Name:
Provider Other Organization Name Type Code:
Provider Other Last Name:
Provider Other First Name:
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NPI Number Information

NPI Number:
1013164748
Entity Type Code:
Organization
Replacement NPI:
Last Update Date:
09/09/2008
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
1 ELLIOT WAY
Provider Second Line Business Mailing Address:
SUITE 200
Provider Business Mailing Address City Name:
MANCHESTER
Provider Business Mailing Address State Name:
NH
Provider Business Mailing Address Postal Code:
03103-3502
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
603-669-2315
Provider Business Mailing Address Fax Number:
603-647-9180

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
70 EAST ST
Provider Second Line Business Practice Location Address:
Provider Business Practice Location Address City Name:
METHUEN
Provider Business Practice Location Address State Name:
MA
Provider Business Practice Location Address Postal Code:
01844-4597
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
978-687-0156
Provider Business Practice Location Address Fax Number:
978-681-7581
Provider Enumeration Date:
08/25/2008

Additional Information

			
		

Authorized Official

Authorized Official Last Name:
HYATT
Authorized Official First Name:
JOSEPH
Authorized Official Middle Name:
Authorized Official Title or Position:
MANAGING MEMBER
Authorized Official Telephone Number:
603-663-2315

Provider Taxonomy Codes

  • Taxonomy code: 207LP2900X ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .

Other Provider's Identifiers (legacy, non-NPI)