Provider Demographics
NPI:1669706214
Name:PEGASUS EMERGENCY GROUP GADSDEN, LLC
Entity type:Organization
Organization Name:PEGASUS EMERGENCY GROUP GADSDEN, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:MD
Authorized Official - Prefix:DR
Authorized Official - First Name:NEIL
Authorized Official - Middle Name:E
Authorized Official - Last Name:SCHAMBAN
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:256-737-2106
Mailing Address - Street 1:PO BOX 202708
Mailing Address - Street 2:
Mailing Address - City:DALLAS
Mailing Address - State:TX
Mailing Address - Zip Code:75320-2708
Mailing Address - Country:US
Mailing Address - Phone:866-935-6774
Mailing Address - Fax:781-937-6442
Practice Address - Street 1:1007 GOODYEAR AVE
Practice Address - Street 2:
Practice Address - City:GADSDEN
Practice Address - State:AL
Practice Address - Zip Code:35903-1195
Practice Address - Country:US
Practice Address - Phone:256-737-2106
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2009-09-30
Last Update Date:2009-11-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207P00000XAllopathic & Osteopathic PhysiciansEmergency MedicineGroup - Multi-Specialty