Provider Demographics
NPI:1720364177
Name:ANESTHESIA MANAGEMENT SERVICES, LLC
Entity Type:Organization
Organization Name:ANESTHESIA MANAGEMENT SERVICES, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER/PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:ATUL
Authorized Official - Middle Name:
Authorized Official - Last Name:VAHIL
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:719-546-2500
Mailing Address - Street 1:1600 N GRAND AVE
Mailing Address - Street 2:SUITE 420
Mailing Address - City:PUEBLO
Mailing Address - State:CO
Mailing Address - Zip Code:81003-2700
Mailing Address - Country:US
Mailing Address - Phone:719-546-2500
Mailing Address - Fax:719-546-2335
Practice Address - Street 1:1600 N GRAND AVE
Practice Address - Street 2:SUITE 420
Practice Address - City:PUEBLO
Practice Address - State:CO
Practice Address - Zip Code:81003-2700
Practice Address - Country:US
Practice Address - Phone:719-546-2500
Practice Address - Fax:719-546-2335
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2011-10-31
Last Update Date:2011-10-31
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes367500000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse Anesthetist, Certified RegisteredGroup - Multi-Specialty