Healthcare Provider Details

I. General information

NPI: 1295702496
Provider Name (Legal Business Name): MIDWEST ANESTHESIA SERVICES LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 03/07/2006
Last Update Date: 05/26/2011
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

7205 W CENTER RD
OMAHA NE
68124-2380
US

IV. Provider business mailing address

PO BOX 388
NEWTON KS
67114-0388
US

V. Phone/Fax

Practice location:
  • Phone: 402-926-2425
  • Fax:
Mailing address:
  • Phone: 316-281-3700
  • Fax: 316-282-4322

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code367500000X
TaxonomyCertified Registered Nurse Anesthetist
License Number
License Number State

VIII. Authorized Official

Name: THOMAS CLAIR RICE
Title or Position: MANAGING MEMBER
Credential: CRNA
Phone: 402-397-1180