Provider Demographics
NPI:1093263519
Name:BIOGASTREX, LLC
Entity Type:Organization
Organization Name:BIOGASTREX, LLC
Other - Org Name:EXCELSIOR ANESTHESIA
Other - Org Type:Doing Business As
Authorized Official - Title/Position:PHYSICIAN
Authorized Official - Prefix:DR
Authorized Official - First Name:ADISESHA
Authorized Official - Middle Name:B
Authorized Official - Last Name:REDDY
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:205-345-0010
Mailing Address - Street 1:100 RICE MINE RD N
Mailing Address - Street 2:SUITE E
Mailing Address - City:TUSCALOOSA
Mailing Address - State:AL
Mailing Address - Zip Code:35406-2300
Mailing Address - Country:US
Mailing Address - Phone:205-345-0010
Mailing Address - Fax:205-752-1175
Practice Address - Street 1:100 RICE MINE RD N
Practice Address - Street 2:SUITE E
Practice Address - City:TUSCALOOSA
Practice Address - State:AL
Practice Address - Zip Code:35406-2300
Practice Address - Country:US
Practice Address - Phone:205-345-0010
Practice Address - Fax:205-752-1175
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2016-09-13
Last Update Date:2016-09-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207RG0100XAllopathic & Osteopathic PhysiciansInternal MedicineGastroenterologyGroup - Single Specialty