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NPI Code Detail

MEDICARE: PINNACLE ANESTHESIA SERVICES ASPEN MOUNTAIN LLC

MEDICARE: PINNACLE ANESTHESIA SERVICES ASPEN MOUNTAIN LLC
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
1207L00000XAnesthesiology Physician

General Provider Information

NPI Number : 1821452509
Entity Type Code : Organization
Provider Name (Legal Business Name) : PINNACLE ANESTHESIA SERVICES ASPEN MOUNTAIN LLC
Provider Business Mailing Address
First Line : PO BOX 2378
Second Line :
City : DURANGO
State : CO
Zip : 81302-2378
Country : US
Telephone Number : 970-375-1550
Fax Number :
Provider Business Practice Location Address
First Line : 4401 COLLEGE DR
Second Line :
City : ROCK SPRINGS
State : WY
Zip : 82901-3507
Country : US
Telephone Number : 307-352-8900
Fax Number : 307-352-8901
Authorized Official
Title or Position : OWNER
Name : DR. RANDALL B RICE
Credential : M.D.
Telephone Number : 970-749-3238
Provider Enumeration Date : 04/08/2016
Last Update Date : 04/08/2016

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Directions to “PINNACLE ANESTHESIA SERVICES ASPEN MOUNTAIN LLC ” Practice Location

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