Provider Demographics
NPI:1497353510
Name:ASC ANESTHESIA, LLC
Entity Type:Organization
Organization Name:ASC ANESTHESIA, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:JULIE
Authorized Official - Middle Name:
Authorized Official - Last Name:SPRENKEL
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:937-853-4284
Mailing Address - Street 1:7211 N MAIN ST STE 2
Mailing Address - Street 2:
Mailing Address - City:DAYTON
Mailing Address - State:OH
Mailing Address - Zip Code:45415-2560
Mailing Address - Country:US
Mailing Address - Phone:937-313-0081
Mailing Address - Fax:
Practice Address - Street 1:7211 N MAIN ST STE 2
Practice Address - Street 2:
Practice Address - City:DAYTON
Practice Address - State:OH
Practice Address - Zip Code:45415-2560
Practice Address - Country:US
Practice Address - Phone:937-313-0081
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2020-10-12
Last Update Date:2020-10-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207L00000XAllopathic & Osteopathic PhysiciansAnesthesiologyGroup - Single Specialty