Provider Demographics
NPI:1871854059
Name:CBSI NEUROANESTHESIA LLC
Entity Type:Organization
Organization Name:CBSI NEUROANESTHESIA LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:BUSINESS MANAGER
Authorized Official - Prefix:MRS
Authorized Official - First Name:KATHRYN
Authorized Official - Middle Name:S
Authorized Official - Last Name:PENNER-SIMONSON
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:303-783-7645
Mailing Address - Street 1:499 E HAMPDEN AVE
Mailing Address - Street 2:STE 220
Mailing Address - City:ENGLEWOOD
Mailing Address - State:CO
Mailing Address - Zip Code:80113-2780
Mailing Address - Country:US
Mailing Address - Phone:303-783-8844
Mailing Address - Fax:303-783-2002
Practice Address - Street 1:499 E HAMPDEN AVE
Practice Address - Street 2:STE 220
Practice Address - City:ENGLEWOOD
Practice Address - State:CO
Practice Address - Zip Code:80113-2780
Practice Address - Country:US
Practice Address - Phone:303-783-8844
Practice Address - Fax:303-783-2002
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2012-06-04
Last Update Date:2012-10-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207L00000XAllopathic & Osteopathic PhysiciansAnesthesiologyGroup - Single Specialty