Provider Demographics
NPI:1629247010
Name:SOMC MEDICAL CARE FOUNDATION, INC.
Entity Type:Organization
Organization Name:SOMC MEDICAL CARE FOUNDATION, INC.
Other - Org Name:SOMC ANESTHESIA ASSOCIATES
Other - Org Type:Doing Business As
Authorized Official - Title/Position:ADMINISTATIVE DIRECTOR
Authorized Official - Prefix:MRS
Authorized Official - First Name:REBECCA
Authorized Official - Middle Name:L
Authorized Official - Last Name:FITE
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:740-356-8008
Mailing Address - Street 1:1735 27TH ST
Mailing Address - Street 2:BUILDING C, SUITE B06
Mailing Address - City:PORTSMOUTH
Mailing Address - State:OH
Mailing Address - Zip Code:45662-2677
Mailing Address - Country:US
Mailing Address - Phone:740-356-8681
Mailing Address - Fax:740-356-1256
Practice Address - Street 1:1805 27TH ST
Practice Address - Street 2:
Practice Address - City:PORTSMOUTH
Practice Address - State:OH
Practice Address - Zip Code:45662-2640
Practice Address - Country:US
Practice Address - Phone:740-356-8681
Practice Address - Fax:740-356-1256
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:SOMC MEDICAL CARE FOUNDATION, INC
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2008-02-29
Last Update Date:2024-01-31
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207L00000XAllopathic & Osteopathic PhysiciansAnesthesiologyGroup - Single Specialty
No367500000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse Anesthetist, Certified RegisteredGroup - Single Specialty