Provider Demographics
NPI:1205937729
Name:CRAWFORD COUNTY ANESTHESIOLOGY INC
Entity type:Organization
Organization Name:CRAWFORD COUNTY ANESTHESIOLOGY INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:BILLING AGENT
Authorized Official - Prefix:
Authorized Official - First Name:MICHAEL
Authorized Official - Middle Name:
Authorized Official - Last Name:RAHE
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:614-235-2326
Mailing Address - Street 1:PO BOX 13149
Mailing Address - Street 2:
Mailing Address - City:COLUMBUS
Mailing Address - State:OH
Mailing Address - Zip Code:43213-0149
Mailing Address - Country:US
Mailing Address - Phone:614-235-2326
Mailing Address - Fax:614-235-5194
Practice Address - Street 1:20 MORRIS RD
Practice Address - Street 2:
Practice Address - City:SHELBY
Practice Address - State:OH
Practice Address - Zip Code:44875-1152
Practice Address - Country:US
Practice Address - Phone:614-235-2326
Practice Address - Fax:614-235-5194
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-09-26
Last Update Date:2009-05-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207L00000XAllopathic & Osteopathic PhysiciansAnesthesiologyGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
OH2217327Medicaid
OH9306683Medicare ID - Type Unspecified