Provider Demographics
NPI:1649616947
Name:WOOSTER PAIN AND ANESTHESIA CENTER LLC
Entity type:Organization
Organization Name:WOOSTER PAIN AND ANESTHESIA CENTER LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:AUTHORIZED REPRESENTATIVE
Authorized Official - Prefix:
Authorized Official - First Name:MAHER
Authorized Official - Middle Name:J
Authorized Official - Last Name:ZACKARY
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:330-284-9119
Mailing Address - Street 1:3373 COMMERCE PKWY
Mailing Address - Street 2:SUITE 3
Mailing Address - City:WOOSTER
Mailing Address - State:OH
Mailing Address - Zip Code:44691-7130
Mailing Address - Country:US
Mailing Address - Phone:330-439-4656
Mailing Address - Fax:888-833-4132
Practice Address - Street 1:3373 COMMERCE PKWY
Practice Address - Street 2:SUITE 3
Practice Address - City:WOOSTER
Practice Address - State:OH
Practice Address - Zip Code:44691-7130
Practice Address - Country:US
Practice Address - Phone:330-284-9119
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2013-05-14
Last Update Date:2022-10-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207LP2900XAllopathic & Osteopathic PhysiciansAnesthesiologyPain MedicineGroup - Multi-Specialty