Provider Demographics
NPI:1245623834
Name:ELITE ANESTHESIA, LLC
Entity type:Organization
Organization Name:ELITE ANESTHESIA, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER/AUTHORIZED OFFICIAL
Authorized Official - Prefix:DR
Authorized Official - First Name:PATRICK
Authorized Official - Middle Name:W
Authorized Official - Last Name:HOGAN
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:602-795-8700
Mailing Address - Street 1:2040 S. ALMA SCHOOL RD PO BOX 493
Mailing Address - Street 2:
Mailing Address - City:CHANDLER
Mailing Address - State:AZ
Mailing Address - Zip Code:85286-0493
Mailing Address - Country:US
Mailing Address - Phone:602-795-8700
Mailing Address - Fax:
Practice Address - Street 1:18555 N 79TH AVE
Practice Address - Street 2:BUILDING C
Practice Address - City:GLENDALE
Practice Address - State:AZ
Practice Address - Zip Code:85308-8370
Practice Address - Country:US
Practice Address - Phone:623-776-2500
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2015-03-06
Last Update Date:2018-02-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes367500000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse Anesthetist, Certified RegisteredGroup - Single Specialty