Provider Demographics
NPI:1104623917
Name:PEAK ANESTHESIA STAFFING SOLUTIONS LLC
Entity type:Organization
Organization Name:PEAK ANESTHESIA STAFFING SOLUTIONS LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:BRIAN
Authorized Official - Middle Name:WAYNE
Authorized Official - Last Name:CHURCH
Authorized Official - Suffix:
Authorized Official - Credentials:CRNA
Authorized Official - Phone:614-668-2771
Mailing Address - Street 1:PO BOX 751541
Mailing Address - Street 2:
Mailing Address - City:DAYTON
Mailing Address - State:OH
Mailing Address - Zip Code:45475-1541
Mailing Address - Country:US
Mailing Address - Phone:937-203-0603
Mailing Address - Fax:937-936-1149
Practice Address - Street 1:1118 FAIRINGTON DR
Practice Address - Street 2:
Practice Address - City:SIDNEY
Practice Address - State:OH
Practice Address - Zip Code:45365-8913
Practice Address - Country:US
Practice Address - Phone:937-203-0603
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2025-02-27
Last Update Date:2025-02-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes367500000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse Anesthetist, Certified RegisteredGroup - Single Specialty