Healthcare Provider Details

I. General information

NPI: 1700601903
Provider Name (Legal Business Name): AUSTRALIA ANESTHESIA MANAGEMENT LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 11/21/2024
Last Update Date: 03/12/2025
Certification Date: 03/12/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

200 HIGH PARK AVE
GOSHEN IN
46526-4810
US

IV. Provider business mailing address

PO BOX 830811
PHILADELPHIA PA
19182-0811
US

V. Phone/Fax

Practice location:
  • Phone: 574-364-1000
  • Fax:
Mailing address:
  • Phone: 888-987-1489
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207L00000X
TaxonomyAnesthesiology Physician
License Number
License Number State

VIII. Authorized Official

Name: MARGARITE GARNER
Title or Position: VICE PRESIDENT OPERATIONS
Credential:
Phone: 904-298-9590