Provider Demographics
NPI:1184114605
Name:RED CLIFFS ANESTHESIA, INC
Entity type:Organization
Organization Name:RED CLIFFS ANESTHESIA, INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:JOHN
Authorized Official - Middle Name:O
Authorized Official - Last Name:HARMON
Authorized Official - Suffix:
Authorized Official - Credentials:CRNA
Authorized Official - Phone:801-787-2827
Mailing Address - Street 1:2130 E WYOMING DR
Mailing Address - Street 2:
Mailing Address - City:SAINT GEORGE
Mailing Address - State:UT
Mailing Address - Zip Code:84770-2204
Mailing Address - Country:US
Mailing Address - Phone:801-787-2827
Mailing Address - Fax:
Practice Address - Street 1:754 S MAIN ST STE 3
Practice Address - Street 2:
Practice Address - City:SAINT GEORGE
Practice Address - State:UT
Practice Address - Zip Code:84770
Practice Address - Country:US
Practice Address - Phone:801-787-2827
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:RED CLIFFS ANESTHESIA, INC
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2018-05-10
Last Update Date:2018-07-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
UT262390-4406367500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes367500000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse Anesthetist, Certified RegisteredGroup - Single Specialty