Provider Demographics
NPI:1588196349
Name:PRECISE ANESTHETIC,LLC
Entity Type:Organization
Organization Name:PRECISE ANESTHETIC,LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CRNA
Authorized Official - Prefix:
Authorized Official - First Name:HAMID
Authorized Official - Middle Name:R
Authorized Official - Last Name:KHAIRGHADAM
Authorized Official - Suffix:
Authorized Official - Credentials:NURSE ANESTHETIST
Authorized Official - Phone:410-652-4598
Mailing Address - Street 1:2060 PHILLIPS MILL RD
Mailing Address - Street 2:
Mailing Address - City:FOREST HILL
Mailing Address - State:MD
Mailing Address - Zip Code:21050-2119
Mailing Address - Country:US
Mailing Address - Phone:410-652-4598
Mailing Address - Fax:
Practice Address - Street 1:3401 BOX HILL CORPORATE CENTER DR
Practice Address - Street 2:
Practice Address - City:ABINGDON
Practice Address - State:MD
Practice Address - Zip Code:21009-1200
Practice Address - Country:US
Practice Address - Phone:410-652-4598
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:PRECISE ANESTHETIC,LLC
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2017-03-31
Last Update Date:2017-03-31
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MDR137569261QA1903X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QA1903XAmbulatory Health Care FacilitiesClinic/CenterAmbulatory Surgical