Provider Demographics
NPI:1083721427
Name:ADVANCED PAIN AND ANESTHESIA SERVICES, PC
Entity Type:Organization
Organization Name:ADVANCED PAIN AND ANESTHESIA SERVICES, PC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRES/OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:VITALIY
Authorized Official - Middle Name:
Authorized Official - Last Name:DOMASHEVICH
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:303-927-7197
Mailing Address - Street 1:PO BOX 17485
Mailing Address - Street 2:
Mailing Address - City:DENVER
Mailing Address - State:CO
Mailing Address - Zip Code:80217-0485
Mailing Address - Country:US
Mailing Address - Phone:303-927-7197
Mailing Address - Fax:303-927-7197
Practice Address - Street 1:15728 E PRENTICE LN
Practice Address - Street 2:
Practice Address - City:CENTENNIAL
Practice Address - State:CO
Practice Address - Zip Code:80015-4263
Practice Address - Country:US
Practice Address - Phone:303-927-7197
Practice Address - Fax:303-927-7197
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-08-23
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Not Answered207L00000XAllopathic & Osteopathic PhysiciansAnesthesiologyGroup - Multi-Specialty
Not Answered207LP2900XAllopathic & Osteopathic PhysiciansAnesthesiologyPain MedicineGroup - Multi-Specialty