Provider Demographics
NPI:1811371230
Name:CENTURY OAK ANESTHESIA, LLC
Entity Type:Organization
Organization Name:CENTURY OAK ANESTHESIA, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:CHRISTA
Authorized Official - Middle Name:HARDY
Authorized Official - Last Name:SWIGER
Authorized Official - Suffix:
Authorized Official - Credentials:CRNA
Authorized Official - Phone:985-502-4104
Mailing Address - Street 1:124 CENTURY OAK LN
Mailing Address - Street 2:
Mailing Address - City:MANDEVILLE
Mailing Address - State:LA
Mailing Address - Zip Code:70471-6436
Mailing Address - Country:US
Mailing Address - Phone:985-502-4104
Mailing Address - Fax:985-247-8280
Practice Address - Street 1:171704 S I 12 SERVICE ROAD
Practice Address - Street 2:
Practice Address - City:HAMMOND
Practice Address - State:LA
Practice Address - Zip Code:70403
Practice Address - Country:US
Practice Address - Phone:985-375-1112
Practice Address - Fax:985-247-8280
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2015-07-15
Last Update Date:2016-06-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes367500000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse Anesthetist, Certified RegisteredGroup - Multi-Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
LA1439061Medicaid
LA438133Medicare PIN