Provider Demographics
NPI:1841305547
Name:ORANGEBURG ANESTHESIA ASSOCIATES, P.A.
Entity type:Organization
Organization Name:ORANGEBURG ANESTHESIA ASSOCIATES, P.A.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:GARY
Authorized Official - Middle Name:A
Authorized Official - Last Name:DELANEY
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:803-533-0664
Mailing Address - Street 1:1175 COOK RD STE 125
Mailing Address - Street 2:
Mailing Address - City:ORANGEBURG
Mailing Address - State:SC
Mailing Address - Zip Code:29118-8201
Mailing Address - Country:US
Mailing Address - Phone:803-533-0664
Mailing Address - Fax:803-533-0668
Practice Address - Street 1:1175 COOK RD STE 125
Practice Address - Street 2:
Practice Address - City:ORANGEBURG
Practice Address - State:SC
Practice Address - Zip Code:29118-8201
Practice Address - Country:US
Practice Address - Phone:803-533-0664
Practice Address - Fax:803-533-0668
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-08-20
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
SC9016 AND 9355207L00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207L00000XAllopathic & Osteopathic PhysiciansAnesthesiologyGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
SC000000156423OtherUNISON THOMAS NORTHRUP
SC090163Medicaid
SC20-00578OtherCAROLINA CARE TE NORTHRUP
SC093552Medicaid
SC20-00375OtherCAROLINA CARE GA DELANEY
SC621520OtherSELECT HEALTH TE NORTHRUP
SC183699OtherMEDCOST GA DELANEY
SC183698OtherMEDCOST THOMAS NORTHRUP
SC620477OtherSELECT HEALTH GA DELANEY
SC000000156416OtherUNISON GARY DELANEY
SC090163Medicaid
SC183699OtherMEDCOST GA DELANEY
SC093552Medicaid