Provider Demographics
NPI:1073934675
Name:CAPSTONE ANESTHESIA SERVICES, LLC
Entity Type:Organization
Organization Name:CAPSTONE ANESTHESIA SERVICES, LLC
Other - Org Name:NORTH RIVER ANESTHESIA ASSOCIATES, LLC
Other - Org Type:Former Legal Business Name
Authorized Official - Title/Position:MEMBER
Authorized Official - Prefix:
Authorized Official - First Name:THOMAS
Authorized Official - Middle Name:WAYNE
Authorized Official - Last Name:HOFFMAN
Authorized Official - Suffix:
Authorized Official - Credentials:CRNA
Authorized Official - Phone:205-566-4607
Mailing Address - Street 1:PO BOX 71087
Mailing Address - Street 2:
Mailing Address - City:TUSCALOOSA
Mailing Address - State:AL
Mailing Address - Zip Code:35407-1087
Mailing Address - Country:US
Mailing Address - Phone:205-566-4607
Mailing Address - Fax:
Practice Address - Street 1:301 RICE MINE RD NE
Practice Address - Street 2:NORTH RIVER SURGICAL CENTER
Practice Address - City:TUSCALOOSA
Practice Address - State:AL
Practice Address - Zip Code:35406-2403
Practice Address - Country:US
Practice Address - Phone:205-750-0022
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2013-12-27
Last Update Date:2015-05-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes367500000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse Anesthetist, Certified RegisteredGroup - Single Specialty