Provider Demographics
NPI:1184924946
Name:MADISON STREET ANESTHESIA LLC
Entity type:Organization
Organization Name:MADISON STREET ANESTHESIA LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:SENIOR VICE PRESIDENT - FINANCE
Authorized Official - Prefix:
Authorized Official - First Name:DAN
Authorized Official - Middle Name:
Authorized Official - Last Name:ZEBARTH
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:303-468-0432
Mailing Address - Street 1:55 MADISON ST
Mailing Address - Street 2:355
Mailing Address - City:DENVER
Mailing Address - State:CO
Mailing Address - Zip Code:80206-5419
Mailing Address - Country:US
Mailing Address - Phone:303-377-2020
Mailing Address - Fax:303-377-2022
Practice Address - Street 1:55 MADISON ST
Practice Address - Street 2:355
Practice Address - City:DENVER
Practice Address - State:CO
Practice Address - Zip Code:80206-5419
Practice Address - Country:US
Practice Address - Phone:303-377-2020
Practice Address - Fax:303-377-2022
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:MADISON STREET PROVIDER NETWORK
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2010-10-27
Last Update Date:2010-10-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes367500000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse Anesthetist, Certified RegisteredGroup - Single Specialty