Provider Demographics
NPI:1164593430
Name:PROFESSIONAL ANESTHESIA SERVICES
Entity Type:Organization
Organization Name:PROFESSIONAL ANESTHESIA SERVICES
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:ADMINISTRATOR
Authorized Official - Prefix:
Authorized Official - First Name:KAY
Authorized Official - Middle Name:
Authorized Official - Last Name:CARSON
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:402-398-6176
Mailing Address - Street 1:7710 MERCY RD STE 424
Mailing Address - Street 2:
Mailing Address - City:OMAHA
Mailing Address - State:NE
Mailing Address - Zip Code:68124-2346
Mailing Address - Country:US
Mailing Address - Phone:402-343-8760
Mailing Address - Fax:402-343-8765
Practice Address - Street 1:9850 NICHOLAS ST STE 100
Practice Address - Street 2:
Practice Address - City:OMAHA
Practice Address - State:NE
Practice Address - Zip Code:68114-2191
Practice Address - Country:US
Practice Address - Phone:402-343-8760
Practice Address - Fax:402-343-8765
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-11-10
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207L00000XAllopathic & Osteopathic PhysiciansAnesthesiologyGroup - Single Specialty