Provider Demographics
NPI:1235235961
Name:ASSOCIATION OF ANESTHESIA PROVIDERS, LLC
Entity Type:Organization
Organization Name:ASSOCIATION OF ANESTHESIA PROVIDERS, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:MARSHA
Authorized Official - Middle Name:
Authorized Official - Last Name:BOGGESS
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:304-346-9400
Mailing Address - Street 1:PO BOX 1009
Mailing Address - Street 2:
Mailing Address - City:CHARLESTON
Mailing Address - State:WV
Mailing Address - Zip Code:25324-1009
Mailing Address - Country:US
Mailing Address - Phone:304-346-9400
Mailing Address - Fax:304-345-7320
Practice Address - Street 1:1325 LOCUST AVE
Practice Address - Street 2:
Practice Address - City:FAIRMONT
Practice Address - State:WV
Practice Address - Zip Code:26554-1435
Practice Address - Country:US
Practice Address - Phone:304-346-9400
Practice Address - Fax:304-345-7320
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-09-16
Last Update Date:2008-05-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WV16058207L00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207L00000XAllopathic & Osteopathic PhysiciansAnesthesiologyGroup - Multi-Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
WV612330401OtherFEDERAL BLACK LUNG
WV001907643OtherBCBS MD 'PAY TO'
WV612330400OtherFECA
WVDF0767OtherRR MEDICARE
WV3810006746Medicaid
WV001907661OtherBCBS CRNA 'PAY TO' NUMBER
WV1070905OtherBRICKSTREET
WV=========OtherTRICARE
WV612330400OtherFECA
WVDF0767OtherRR MEDICARE
WV1070905OtherBRICKSTREET
WVDF0767OtherRR MEDICARE