Provider Demographics
NPI:1023128915
Name:CHESTER COUNTY ANESTHESIA ASSOC
Entity type:Organization
Organization Name:CHESTER COUNTY ANESTHESIA ASSOC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:BUSINESS MANAGER
Authorized Official - Prefix:
Authorized Official - First Name:WINIFRED
Authorized Official - Middle Name:C
Authorized Official - Last Name:MEALL
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:610-383-8589
Mailing Address - Street 1:213 REECEVILLE ROAD
Mailing Address - Street 2:
Mailing Address - City:COATESVILLE
Mailing Address - State:PA
Mailing Address - Zip Code:19320-1574
Mailing Address - Country:US
Mailing Address - Phone:610-383-8589
Mailing Address - Fax:610-383-5676
Practice Address - Street 1:213 REECEVILLE ROAD
Practice Address - Street 2:
Practice Address - City:COATESVILLE
Practice Address - State:PA
Practice Address - Zip Code:19320-1574
Practice Address - Country:US
Practice Address - Phone:610-383-8589
Practice Address - Fax:610-383-5676
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-08-30
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207L00000XAllopathic & Osteopathic PhysiciansAnesthesiologyGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
PA0931534Medicaid
PA0931534Medicaid