Provider Demographics
NPI:1366482119
Name:ANESTHESIOLOGY CONSULTANTS OF TOLEDO, INC
Entity Type:Organization
Organization Name:ANESTHESIOLOGY CONSULTANTS OF TOLEDO, INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:DIRECTOR OF BILLING
Authorized Official - Prefix:MRS
Authorized Official - First Name:KARYN
Authorized Official - Middle Name:
Authorized Official - Last Name:KOVACH
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:419-531-8808
Mailing Address - Street 1:2914 S REPUBLIC BLVD
Mailing Address - Street 2:
Mailing Address - City:TOLEDO
Mailing Address - State:OH
Mailing Address - Zip Code:43615-1912
Mailing Address - Country:US
Mailing Address - Phone:419-531-8808
Mailing Address - Fax:419-531-8877
Practice Address - Street 1:2142 N COVE BLVD
Practice Address - Street 2:
Practice Address - City:TOLEDO
Practice Address - State:OH
Practice Address - Zip Code:43606-3895
Practice Address - Country:US
Practice Address - Phone:419-531-8808
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-06-08
Last Update Date:2008-06-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207L00000XAllopathic & Osteopathic PhysiciansAnesthesiologyGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
OH2114616Medicaid
OH2114634Medicaid
OH2114652Medicaid
OHCI4875OtherRAILROAD MEDICARE
OH2114652Medicaid
OH9301142Medicare PIN
OH9301141Medicare PIN