Provider Demographics
NPI:1275070740
Name:ANESTHESIA CARE, INC.
Entity Type:Organization
Organization Name:ANESTHESIA CARE, INC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:MR
Authorized Official - First Name:RANDY
Authorized Official - Middle Name:LEE
Authorized Official - Last Name:KARR
Authorized Official - Suffix:
Authorized Official - Credentials:CRNA
Authorized Official - Phone:757-721-5188
Mailing Address - Street 1:4148 GUM BRIDGE CT
Mailing Address - Street 2:
Mailing Address - City:VIRGINIA BEACH
Mailing Address - State:VA
Mailing Address - Zip Code:23457-1593
Mailing Address - Country:US
Mailing Address - Phone:757-721-5188
Mailing Address - Fax:757-215-2350
Practice Address - Street 1:4148 GUM BRIDGE CT
Practice Address - Street 2:
Practice Address - City:VIRGINIA BEACH
Practice Address - State:VA
Practice Address - Zip Code:23457-1593
Practice Address - Country:US
Practice Address - Phone:757-721-5188
Practice Address - Fax:757-215-2350
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2017-01-23
Last Update Date:2017-01-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VA0024074931367500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes367500000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse Anesthetist, Certified RegisteredGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
VA009559108Medicaid
VA009559108Medicaid