Provider Demographics
NPI:1407038490
Name:PEAK ANESTHESIA SERVICES INC.
Entity Type:Organization
Organization Name:PEAK ANESTHESIA SERVICES INC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:MS
Authorized Official - First Name:LAURI
Authorized Official - Middle Name:LOUISE
Authorized Official - Last Name:FERRARO
Authorized Official - Suffix:
Authorized Official - Credentials:CRNA
Authorized Official - Phone:406-585-8428
Mailing Address - Street 1:300 N WILLSON AVE
Mailing Address - Street 2:SAME DAY SURGERY CENTER
Mailing Address - City:BOZEMAN
Mailing Address - State:MT
Mailing Address - Zip Code:59715-3551
Mailing Address - Country:US
Mailing Address - Phone:406-586-1956
Mailing Address - Fax:406-587-7656
Practice Address - Street 1:300 N WILLSON AVE
Practice Address - Street 2:SAME DAY SURGERY CENTER
Practice Address - City:BOZEMAN
Practice Address - State:MT
Practice Address - Zip Code:59715-3551
Practice Address - Country:US
Practice Address - Phone:406-586-1956
Practice Address - Fax:406-587-7656
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-11-30
Last Update Date:2009-12-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MT23075367500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes367500000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse Anesthetist, Certified RegisteredGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
MT4305216Medicaid
MT000084505OtherMEDICARE (GROUP)
MT1699851543OtherMEDICARE INDIVIDUAL NPI
MT000006646OtherMEDICARE (INDIVIDUAL)