1841305547 NPI number — ORANGEBURG ANESTHESIA ASSOCIATES, P.A.

Table of content: HOLLY KANE PA-C (NPI 1093408981)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1841305547 NPI number — ORANGEBURG ANESTHESIA ASSOCIATES, P.A.

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
ORANGEBURG ANESTHESIA ASSOCIATES, P.A.
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:
1841305547
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:
1175 COOK RD STE 125
Provider Second Line Business Mailing Address:
Provider Business Mailing Address City Name:
ORANGEBURG
Provider Business Mailing Address State Name:
SC
Provider Business Mailing Address Postal Code:
29118-8201
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
803-533-0664
Provider Business Mailing Address Fax Number:
803-533-0668

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
1175 COOK RD STE 125
Provider Second Line Business Practice Location Address:
Provider Business Practice Location Address City Name:
ORANGEBURG
Provider Business Practice Location Address State Name:
SC
Provider Business Practice Location Address Postal Code:
29118-8201
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
803-533-0664
Provider Business Practice Location Address Fax Number:
803-533-0668
Provider Enumeration Date:
08/20/2006

Additional Information

Authorized Official

Authorized Official Last Name:
DELANEY
Authorized Official First Name:
GARY
Authorized Official Middle Name:
A
Authorized Official Title or Position:
PRESIDENT
Authorized Official Telephone Number:
803-533-0664

Provider Taxonomy Codes

  • Taxonomy code: 207L00000X , with the licence number:  9016 AND 9355 , registered in the state of SC ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .

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

  • Identifier: 000000156423 . This is a "UNISON THOMAS NORTHRUP" identifier , issued by the state of ( SC ) . This identifiers is of the category "OTHER".
  • Identifier: 090163 , issued by the state of ( SC ) . This identifiers is of the category "MEDICAID".
  • Identifier: 20-00578 . This is a "CAROLINA CARE TE NORTHRUP" identifier , issued by the state of ( SC ) . This identifiers is of the category "OTHER".
  • Identifier: 093552 , issued by the state of ( SC ) . This identifiers is of the category "MEDICAID".
  • Identifier: 20-00375 . This is a "CAROLINA CARE GA DELANEY" identifier , issued by the state of ( SC ) . This identifiers is of the category "OTHER".
  • Identifier: 621520 . This is a "SELECT HEALTH TE NORTHRUP" identifier , issued by the state of ( SC ) . This identifiers is of the category "OTHER".
  • Identifier: 183699 . This is a "MEDCOST GA DELANEY" identifier , issued by the state of ( SC ) . This identifiers is of the category "OTHER".
  • Identifier: 183698 . This is a "MEDCOST THOMAS NORTHRUP" identifier , issued by the state of ( SC ) . This identifiers is of the category "OTHER".
  • Identifier: 620477 . This is a "SELECT HEALTH GA DELANEY" identifier , issued by the state of ( SC ) . This identifiers is of the category "OTHER".
  • Identifier: 000000156416 . This is a "UNISON GARY DELANEY" identifier , issued by the state of ( SC ) . This identifiers is of the category "OTHER".




Copyright © 2007-2025 www.npivalidator.com