Provider Demographics
NPI:1871183491
Name:SAPPHIRE ANESTHESIA, LLC
Entity Type:Organization
Organization Name:SAPPHIRE ANESTHESIA, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:DIRECTOR
Authorized Official - Prefix:
Authorized Official - First Name:BRANDIE
Authorized Official - Middle Name:
Authorized Official - Last Name:HERNANDEZ
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:480-204-4593
Mailing Address - Street 1:10375 PARK MEADOWS DR STE 150
Mailing Address - Street 2:
Mailing Address - City:LONE TREE
Mailing Address - State:CO
Mailing Address - Zip Code:80124-6755
Mailing Address - Country:US
Mailing Address - Phone:480-204-4593
Mailing Address - Fax:
Practice Address - Street 1:10375 PARK MEADOWS DR STE 150
Practice Address - Street 2:
Practice Address - City:LONE TREE
Practice Address - State:CO
Practice Address - Zip Code:80124-6755
Practice Address - Country:US
Practice Address - Phone:480-204-4593
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2021-01-19
Last Update Date:2021-01-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QM2500XAmbulatory Health Care FacilitiesClinic/CenterMedical Specialty