1700920469 NPI number — CROSS COUNTRY ANESTHESIA, INC.

Table of content: (NPI 1700920469)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1700920469 NPI number — CROSS COUNTRY ANESTHESIA, INC.

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
CROSS COUNTRY ANESTHESIA, INC.
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:
Provider Other Last Name Type Code:

NPI Number Information

NPI Number:
1700920469
Entity Type Code:
Organization
Replacement NPI:
Last Update Date:
08/22/2020
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
2533 DERBYSHIRE RD
Provider Second Line Business Mailing Address:
Provider Business Mailing Address City Name:
CLEVELAND HTS
Provider Business Mailing Address State Name:
OH
Provider Business Mailing Address Postal Code:
44106-3230
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
216-932-4522
Provider Business Mailing Address Fax Number:
216-928-0141

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
2533 DERBYSHIRE RD
Provider Second Line Business Practice Location Address:
Provider Business Practice Location Address City Name:
CLEVELAND HTS
Provider Business Practice Location Address State Name:
OH
Provider Business Practice Location Address Postal Code:
44106-3230
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
216-932-4522
Provider Business Practice Location Address Fax Number:
216-928-0141
Provider Enumeration Date:
02/16/2007

Additional Information

Authorized Official

Authorized Official Last Name:
GISEL
Authorized Official First Name:
LINCOLN
Authorized Official Middle Name:
DANIEL
Authorized Official Title or Position:
PRESIDENT
Authorized Official Telephone Number:
216-932-4522

Provider Taxonomy Codes

  • Taxonomy code: 367500000X , with the licence number:  050966 , registered in the state of OH ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .

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

  • Identifier: 00216277 . This is a "RAILROAD MEDICARE" identifier , issued by the state of ( OH ) . This identifiers is of the category "OTHER".




Copyright © 2007-2025 www.npivalidator.com