Provider Demographics
NPI:1720266893
Name:ANESTHESIA & PAIN CONTROL SERVICES, INC
Entity Type:Organization
Organization Name:ANESTHESIA & PAIN CONTROL SERVICES, INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:GENERAL MANAGER
Authorized Official - Prefix:MRS
Authorized Official - First Name:STACEY
Authorized Official - Middle Name:M
Authorized Official - Last Name:TSANG
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:626-512-6348
Mailing Address - Street 1:PO BOX 6189
Mailing Address - Street 2:
Mailing Address - City:DIBERVILLE
Mailing Address - State:MS
Mailing Address - Zip Code:39540-6189
Mailing Address - Country:US
Mailing Address - Phone:228-273-4096
Mailing Address - Fax:866-809-7246
Practice Address - Street 1:2810 ANDREW AVE
Practice Address - Street 2:
Practice Address - City:PASCAGOULA
Practice Address - State:MS
Practice Address - Zip Code:39567-1802
Practice Address - Country:US
Practice Address - Phone:228-273-4096
Practice Address - Fax:866-809-7246
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2008-01-31
Last Update Date:2009-08-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MSW0714282207LP2900X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207LP2900XAllopathic & Osteopathic PhysiciansAnesthesiologyPain MedicineGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
MS08886328Medicaid
MSC02961Medicare PIN