Provider Demographics
NPI:1568409076
Name:GREENEVILLE ANESTHESIA SERVICES
Entity Type:Organization
Organization Name:GREENEVILLE ANESTHESIA SERVICES
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CHIEF
Authorized Official - Prefix:MR
Authorized Official - First Name:MEARLE
Authorized Official - Middle Name:E
Authorized Official - Last Name:MEYER
Authorized Official - Suffix:
Authorized Official - Credentials:CRNA
Authorized Official - Phone:423-956-3134
Mailing Address - Street 1:PO BOX 896138
Mailing Address - Street 2:
Mailing Address - City:CHARLOTTE
Mailing Address - State:NC
Mailing Address - Zip Code:28289-6138
Mailing Address - Country:US
Mailing Address - Phone:423-693-0941
Mailing Address - Fax:423-638-3401
Practice Address - Street 1:1104 TUSCULUM BLVD
Practice Address - Street 2:SUITE 114
Practice Address - City:GREENEVILLE
Practice Address - State:TN
Practice Address - Zip Code:37745-4091
Practice Address - Country:US
Practice Address - Phone:833-500-9914
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-06-01
Last Update Date:2022-09-22
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
TN3734481Medicaid
TN3734481OtherMEDICARE, PART B
TN3734481Medicaid