Provider Demographics
NPI:1154473494
Name:PREMIER ANESTHESIOLOGISTS, LTD.
Entity Type:Organization
Organization Name:PREMIER ANESTHESIOLOGISTS, LTD.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:RALPH
Authorized Official - Middle Name:A
Authorized Official - Last Name:FARINA
Authorized Official - Suffix:JR
Authorized Official - Credentials:MD
Authorized Official - Phone:614-451-0500
Mailing Address - Street 1:PO BOX 14845
Mailing Address - Street 2:
Mailing Address - City:COLUMBUS
Mailing Address - State:OH
Mailing Address - Zip Code:43214-0845
Mailing Address - Country:US
Mailing Address - Phone:614-761-1255
Mailing Address - Fax:614-761-0849
Practice Address - Street 1:930 BETHEL RD
Practice Address - Street 2:
Practice Address - City:COLUMBUS
Practice Address - State:OH
Practice Address - Zip Code:43214-1906
Practice Address - Country:US
Practice Address - Phone:614-451-0500
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-01-17
Last Update Date:2013-10-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207L00000XAllopathic & Osteopathic PhysiciansAnesthesiologyGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
OH2077872Medicaid
OH2077872Medicaid