Provider Demographics
NPI:1922029107
Name:CARAWAY ANESTHESIA INC.
Entity Type:Organization
Organization Name:CARAWAY ANESTHESIA INC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:WILLIAM
Authorized Official - Middle Name:KENT
Authorized Official - Last Name:CARAWAY
Authorized Official - Suffix:JR
Authorized Official - Credentials:CRNA
Authorized Official - Phone:337-616-7150
Mailing Address - Street 1:PO BOX 831
Mailing Address - Street 2:
Mailing Address - City:JENNINGS
Mailing Address - State:LA
Mailing Address - Zip Code:70546-0831
Mailing Address - Country:US
Mailing Address - Phone:337-616-7150
Mailing Address - Fax:337-616-7164
Practice Address - Street 1:1634 ELTON RD
Practice Address - Street 2:
Practice Address - City:JENNINGS
Practice Address - State:LA
Practice Address - Zip Code:70546-3614
Practice Address - Country:US
Practice Address - Phone:337-616-7150
Practice Address - Fax:337-616-7164
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-07-22
Last Update Date:2007-10-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
LA163W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes163W00000XNursing Service ProvidersRegistered NurseGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
LA5CW16Medicare PIN