1376690966 NPI number — ANESTHESIA AND INTENSIVE CARE SPECIALISTS LLP

Table of content: (NPI 1376690966)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1376690966 NPI number — ANESTHESIA AND INTENSIVE CARE SPECIALISTS LLP

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
ANESTHESIA AND INTENSIVE CARE SPECIALISTS LLP
Provider Last Name:
Provider First Name:
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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:
1376690966
Entity Type Code:
Organization
Replacement NPI:
Last Update Date:
05/08/2017
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
6130 ELTON AVE
Provider Second Line Business Mailing Address:
SUITE 113
Provider Business Mailing Address City Name:
LAS VEGAS
Provider Business Mailing Address State Name:
NV
Provider Business Mailing Address Postal Code:
89107-2538
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
702-476-0297
Provider Business Mailing Address Fax Number:
188-834-0242

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
6130 ELTON AVE
Provider Second Line Business Practice Location Address:
SUITE 113
Provider Business Practice Location Address City Name:
LAS VEGAS
Provider Business Practice Location Address State Name:
NV
Provider Business Practice Location Address Postal Code:
89107-2538
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
702-476-0297
Provider Business Practice Location Address Fax Number:
888-340-2427
Provider Enumeration Date:
01/04/2007

Additional Information

Authorized Official

Authorized Official Last Name:
HAGER
Authorized Official First Name:
BRIAN
Authorized Official Middle Name:
C
Authorized Official Title or Position:
RESIDENT AGENT
Authorized Official Telephone Number:
702-686-9347

Provider Taxonomy Codes

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

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





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