Provider Demographics
NPI:1275563108
Name:GUARDIAN ANESTHESIA SERVICES, LLC
Entity Type:Organization
Organization Name:GUARDIAN ANESTHESIA SERVICES, LLC
Other - Org Name:GUARDIAN ANESTHESIA SERVICES, LLC
Other - Org Type:Doing Business As
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:MR
Authorized Official - First Name:HAL
Authorized Official - Middle Name:D
Authorized Official - Last Name:LAMB
Authorized Official - Suffix:
Authorized Official - Credentials:CRNA
Authorized Official - Phone:985-796-5428
Mailing Address - Street 1:27327 DRIFTWOOD RD
Mailing Address - Street 2:
Mailing Address - City:FOLSOM
Mailing Address - State:LA
Mailing Address - Zip Code:70437-7933
Mailing Address - Country:US
Mailing Address - Phone:985-796-5428
Mailing Address - Fax:985-871-9738
Practice Address - Street 1:27327 DRIFTWOOD RD
Practice Address - Street 2:
Practice Address - City:FOLSOM
Practice Address - State:LA
Practice Address - Zip Code:70437-7933
Practice Address - Country:US
Practice Address - Phone:985-796-5428
Practice Address - Fax:985-871-9738
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-07-04
Last Update Date:2008-04-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes367500000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse Anesthetist, Certified RegisteredGroup - Multi-Specialty
No207L00000XAllopathic & Osteopathic PhysiciansAnesthesiologyGroup - Multi-Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
LA1001210Medicaid
LA=========0OtherBLUE CROSS
LA1001210Medicaid