Provider Demographics
NPI:1700334067
Name:SUPERIOR ANESTHESIA
Entity Type:Organization
Organization Name:SUPERIOR ANESTHESIA
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:MANAGER
Authorized Official - Prefix:
Authorized Official - First Name:RYAN
Authorized Official - Middle Name:DAVID
Authorized Official - Last Name:HELMER
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:620-705-5386
Mailing Address - Street 1:2913 YAEGER DR
Mailing Address - Street 2:
Mailing Address - City:WINFIELD
Mailing Address - State:KS
Mailing Address - Zip Code:67156-8533
Mailing Address - Country:US
Mailing Address - Phone:620-705-5386
Mailing Address - Fax:620-221-2948
Practice Address - Street 1:2913 YAEGER DR
Practice Address - Street 2:
Practice Address - City:WINFIELD
Practice Address - State:KS
Practice Address - Zip Code:67156-8533
Practice Address - Country:US
Practice Address - Phone:620-705-5386
Practice Address - Fax:620-221-2948
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2016-09-15
Last Update Date:2016-09-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes367500000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse Anesthetist, Certified RegisteredGroup - Single Specialty