Provider Demographics
NPI:1043714322
Name:ASB PAIN SERVICES, LLC
Entity Type:Organization
Organization Name:ASB PAIN SERVICES, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:BOARD MEMBER
Authorized Official - Prefix:
Authorized Official - First Name:ANTHONY
Authorized Official - Middle Name:B
Authorized Official - Last Name:COOK
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:205-933-7246
Mailing Address - Street 1:2151 OLD ROCKY RIDGE RD, STE 106
Mailing Address - Street 2:ATTN: LYNN BLASZCZAK
Mailing Address - City:BIRMINGHAM
Mailing Address - State:AL
Mailing Address - Zip Code:35216-7251
Mailing Address - Country:US
Mailing Address - Phone:205-989-1091
Mailing Address - Fax:205-989-1087
Practice Address - Street 1:3316 HIGHWAY 280
Practice Address - Street 2:ATTN: LYNN BLASZCZAK
Practice Address - City:ALEXANDER CITY
Practice Address - State:AL
Practice Address - Zip Code:35010-3369
Practice Address - Country:US
Practice Address - Phone:256-329-7100
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:ANESTHESIA SERVICES OF BIRMINGHAM, P.C.
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2018-03-21
Last Update Date:2022-07-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207LP2900XAllopathic & Osteopathic PhysiciansAnesthesiologyPain MedicineGroup - Single Specialty