Provider Demographics
NPI:1407194368
Name:AVAIL SURGICAL ASSIST, LLC
Entity type:Organization
Organization Name:AVAIL SURGICAL ASSIST, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:RNFA
Authorized Official - Prefix:
Authorized Official - First Name:LORRIE
Authorized Official - Middle Name:
Authorized Official - Last Name:PASTORELLO
Authorized Official - Suffix:
Authorized Official - Credentials:RN
Authorized Official - Phone:405-642-4852
Mailing Address - Street 1:601 SW 25TH ST
Mailing Address - Street 2:
Mailing Address - City:EL RENO
Mailing Address - State:OK
Mailing Address - Zip Code:73036-5961
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:601 SW 25TH ST
Practice Address - Street 2:
Practice Address - City:EL RENO
Practice Address - State:OK
Practice Address - Zip Code:73036-5961
Practice Address - Country:US
Practice Address - Phone:405-642-4852
Practice Address - Fax:405-262-0510
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2013-01-27
Last Update Date:2013-01-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OKR0086013163WR0006X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes163WR0006XNursing Service ProvidersRegistered NurseRegistered Nurse First AssistantGroup - Single Specialty