Provider Demographics
NPI: | 1659062867 |
---|---|
Name: | WEST ANESTHESIA STAFFING LLC |
Entity Type: | Organization |
Organization Name: | WEST ANESTHESIA STAFFING LLC |
Other - Org Name: | |
Other - Org Type: | |
Authorized Official - Title/Position: | PRACTICE ADMINISTRATOR |
Authorized Official - Prefix: | |
Authorized Official - First Name: | POPPY |
Authorized Official - Middle Name: | |
Authorized Official - Last Name: | WALKER |
Authorized Official - Suffix: | |
Authorized Official - Credentials: | MBA |
Authorized Official - Phone: | 325-660-5535 |
Mailing Address - Street 1: | 3301 S 14TH ST STE 16180 |
Mailing Address - Street 2: | |
Mailing Address - City: | ABILENE |
Mailing Address - State: | TX |
Mailing Address - Zip Code: | 79605-5015 |
Mailing Address - Country: | US |
Mailing Address - Phone: | 325-660-5535 |
Mailing Address - Fax: | 325-692-6030 |
Practice Address - Street 1: | 1949 FLORENCE BLVD |
Practice Address - Street 2: | |
Practice Address - City: | FLORENCE |
Practice Address - State: | AL |
Practice Address - Zip Code: | 35630-2729 |
Practice Address - Country: | US |
Practice Address - Phone: | 256-415-8100 |
Practice Address - Fax: | |
EIN: | <UNAVAIL> |
Is Organization Subpart?: | No |
Parent Organization LBN: | |
Parent Organization TIN: | |
Enumeration Date: | 2023-05-18 |
Last Update Date: | 2023-05-18 |
Deactivation Date: | |
Deactivation Code: | |
Reactivation Date: |
Provider Taxonomies
Primary? | Code | Type | Classification | Specialization | Group |
---|---|---|---|---|---|
Yes | 367500000X | Physician Assistants & Advanced Practice Nursing Providers | Nurse Anesthetist, Certified Registered | Group - Single Specialty |