Provider Demographics
NPI:1962653188
Name:EAST COAST ANESTHESIA INC.
Entity Type:Organization
Organization Name:EAST COAST ANESTHESIA INC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:MR
Authorized Official - First Name:RICHARD
Authorized Official - Middle Name:ALAN
Authorized Official - Last Name:PIPPENGER
Authorized Official - Suffix:JR
Authorized Official - Credentials:CRNA
Authorized Official - Phone:443-350-0111
Mailing Address - Street 1:3231 HUNTERSWORTH WAY
Mailing Address - Street 2:
Mailing Address - City:GLENWOOD
Mailing Address - State:MD
Mailing Address - Zip Code:21738
Mailing Address - Country:US
Mailing Address - Phone:443-350-0111
Mailing Address - Fax:
Practice Address - Street 1:3231 HUNTERSWORTH WAY
Practice Address - Street 2:
Practice Address - City:GLENWOOD
Practice Address - State:MD
Practice Address - Zip Code:21738
Practice Address - Country:US
Practice Address - Phone:443-350-0111
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2008-10-07
Last Update Date:2008-10-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QA1903XAmbulatory Health Care FacilitiesClinic/CenterAmbulatory Surgical
Provider Identifiers
StateIdentifier IDID TypeIssuer
MD402548200Medicaid
MD402548200Medicaid