1225408685 NPI number — STRATEGY ANESTHESIA SOUTH CAROLINA LLC

Table of content: (NPI 1225408685)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1225408685 NPI number — STRATEGY ANESTHESIA SOUTH CAROLINA LLC

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
STRATEGY ANESTHESIA SOUTH CAROLINA LLC
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:
Provider Other Middle Name:
Provider Other Name Prefix Text:
Provider Other Name Suffix Text:
Provider Other Credential Text:
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NPI Number Information

NPI Number:
1225408685
Entity Type Code:
Organization
Replacement NPI:
Last Update Date:
10/23/2015
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
3943 IRVINE BLVD
Provider Second Line Business Mailing Address:
STE 628
Provider Business Mailing Address City Name:
IRVINE
Provider Business Mailing Address State Name:
CA
Provider Business Mailing Address Postal Code:
92602-2400
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
703-665-3046
Provider Business Mailing Address Fax Number:
703-991-7269

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
457-E BYPASS 123
Provider Second Line Business Practice Location Address:
Provider Business Practice Location Address City Name:
SENECA
Provider Business Practice Location Address State Name:
SC
Provider Business Practice Location Address Postal Code:
29678-0842
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
855-770-8100
Provider Business Practice Location Address Fax Number:
846-886-9888
Provider Enumeration Date:
09/29/2015

Additional Information

Authorized Official

Authorized Official Last Name:
IRFAN
Authorized Official First Name:
KASHIF
Authorized Official Middle Name:
Authorized Official Title or Position:
AUTHORIZED OFFICIAL
Authorized Official Telephone Number:
703-665-3057

Provider Taxonomy Codes

  • Taxonomy code: 207L00000X ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .

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





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