Provider Demographics
NPI:1801831656
Name:ANESTHESIA ASSOCIATES OF RICHMOND, INC
Entity Type:Organization
Organization Name:ANESTHESIA ASSOCIATES OF RICHMOND, INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRACTICE ADMINISTRATOR
Authorized Official - Prefix:
Authorized Official - First Name:TIMOTHY
Authorized Official - Middle Name:
Authorized Official - Last Name:O'HARE
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:804-288-4453
Mailing Address - Street 1:PO BOX 17978
Mailing Address - Street 2:
Mailing Address - City:RICHMOND
Mailing Address - State:VA
Mailing Address - Zip Code:23226-7978
Mailing Address - Country:US
Mailing Address - Phone:804-288-4453
Mailing Address - Fax:804-288-1621
Practice Address - Street 1:1602 SKIPWITH RD
Practice Address - Street 2:
Practice Address - City:RICHMOND
Practice Address - State:VA
Practice Address - Zip Code:23229-5205
Practice Address - Country:US
Practice Address - Phone:804-289-4937
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-06-17
Last Update Date:2011-12-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207L00000XAllopathic & Osteopathic PhysiciansAnesthesiologyGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
VAC13061OtherRAILROAD MEDICARE PIN #2
VADB4887OtherRAILROAD MEDICARE PIN #3
VACI4798OtherRAILROAD MEDICARE PIN #1
VAC00417Medicare PIN