MEDICARE: ANESTHESIA SERVICES ASSOCIATES, PLLC

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	332B00000X	Durable Medical Equipment & Medical Supplies

General Provider Information

NPI Number	:	1639621105
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	ANESTHESIA SERVICES ASSOCIATES, PLLC

Provider Business Mailing Address
First Line	:	PO BOX 440210
Second Line	:
City	:	NASHVILLE
State	:	TN
Zip	:	37244-0210
Country	:	US
Telephone Number	:
Fax Number	:

Provider Business Practice Location Address
First Line	:	160 W UNIVERSITY PKWY STE C
Second Line	:
City	:	JACKSON
State	:	TN
Zip	:	38305-1667
Country	:	US
Telephone Number	:	731-660-5116
Fax Number	:

Authorized Official
Title or Position	:	CEO
Name	:	PETER KROLL
Credential	:	MD
Telephone Number	:	615-824-3737

Provider Enumeration Date	:	10/31/2016
Last Update Date	:	03/30/2018

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