Provider Demographics
NPI:1912923343
Name:C S ANESTHESIA LLC
Entity Type:Organization
Organization Name:C S ANESTHESIA LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:BRIAN
Authorized Official - Middle Name:NEIL
Authorized Official - Last Name:CROSS
Authorized Official - Suffix:
Authorized Official - Credentials:CRNA
Authorized Official - Phone:330-881-8309
Mailing Address - Street 1:3782 SPERONE DR
Mailing Address - Street 2:
Mailing Address - City:CANFIELD
Mailing Address - State:OH
Mailing Address - Zip Code:44406-9049
Mailing Address - Country:US
Mailing Address - Phone:330-881-8309
Mailing Address - Fax:330-533-4232
Practice Address - Street 1:3020 BELMONT AVE
Practice Address - Street 2:
Practice Address - City:YOUNGSTOWN
Practice Address - State:OH
Practice Address - Zip Code:44505-1846
Practice Address - Country:US
Practice Address - Phone:303-759-7672
Practice Address - Fax:208-523-8978
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-07-15
Last Update Date:2020-04-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OHRN233535367500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes367500000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse Anesthetist, Certified RegisteredGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
PA001829088OtherHIGHMARK
PA1015775750001Medicaid
PA1015775750001Medicaid
PA001829088OtherHIGHMARK