Provider Demographics
NPI:1689982431
Name:TENNESSEE ANESTHESIA NETWORK SERVICES LLC
Entity Type:Organization
Organization Name:TENNESSEE ANESTHESIA NETWORK SERVICES LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:GERALD
Authorized Official - Middle Name:
Authorized Official - Last Name:HAMRICK
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:866-877-2762
Mailing Address - Street 1:PO BOX 890684
Mailing Address - Street 2:
Mailing Address - City:CHARLOTTE
Mailing Address - State:NC
Mailing Address - Zip Code:28289-0684
Mailing Address - Country:US
Mailing Address - Phone:866-877-2762
Mailing Address - Fax:
Practice Address - Street 1:9 PHYSICIANS DR
Practice Address - Street 2:
Practice Address - City:JACKSON
Practice Address - State:TN
Practice Address - Zip Code:38305-2071
Practice Address - Country:US
Practice Address - Phone:731-661-0086
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2010-09-15
Last Update Date:2010-09-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207L00000XAllopathic & Osteopathic PhysiciansAnesthesiologyGroup - Multi-Specialty