Provider Demographics
NPI:1417927641
Name:CENTRAL ANESTHESIA LLC
Entity Type:Organization
Organization Name:CENTRAL ANESTHESIA LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:ALLEN
Authorized Official - Middle Name:
Authorized Official - Last Name:MILHON
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:316-685-6112
Mailing Address - Street 1:PO BOX 2307
Mailing Address - Street 2:
Mailing Address - City:WICHITA
Mailing Address - State:KS
Mailing Address - Zip Code:67201-2307
Mailing Address - Country:US
Mailing Address - Phone:316-685-6112
Mailing Address - Fax:316-652-0340
Practice Address - Street 1:1301 E H ST
Practice Address - Street 2:
Practice Address - City:MC COOK
Practice Address - State:NE
Practice Address - Zip Code:69001-3482
Practice Address - Country:US
Practice Address - Phone:308-345-2650
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-01-23
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes367500000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse Anesthetist, Certified RegisteredGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
NE100250121-00Medicaid
DB0211OtherRAILROAD MEDICARE
099401Medicare ID - Type Unspecified