Healthcare Provider Details
I. General information
NPI: 1811371230
Provider Name (Legal Business Name): CENTURY OAK ANESTHESIA, LLC
Entity Type: Organization
Gender:
Sole Proprietor:
II. Dates (important events)
Enumeration Date: 07/15/2015
Last Update Date: 04/30/2026
Certification Date: 04/30/2026
Deactivation Date:
Reactivation Date:
III. Provider practice location address
1420 N CAUSEWAY BLVD
MANDEVILLE LA
70471-3104
US
IV. Provider business mailing address
124 CENTURY OAK LN
MANDEVILLE LA
70471-6436
US
V. Phone/Fax
- Phone: 985-502-4104
- Fax:
- Phone: 315-975-3500
- Fax: 985-247-8280
VI. Provider taxonomy
Scope of Practice (Provider specialty)
| # 1 | |
| Primary Taxonomy | Y |
| Taxonomy Code | 367500000X |
| Taxonomy | Certified Registered Nurse Anesthetist |
| License Number | |
| License Number State | |
VIII. Authorized Official
Name:
CHRISTA
SWIGER
Title or Position: OWNER
Credential:
Phone: 315-975-3500