Healthcare Provider Details

I. General information

NPI: 1174589725
Provider Name (Legal Business Name): ANESTHESIA CONSULTANTS, INC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 04/24/2006
Last Update Date: 09/28/2015
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2420 LAKE AVE
ASHTABULA OH
44004-4954
US

IV. Provider business mailing address

PO BOX 74751
CLEVELAND OH
44194-0834
US

V. Phone/Fax

Practice location:
  • Phone: 440-997-2262
  • Fax:
Mailing address:
  • Phone: 440-997-2262
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code367500000X
TaxonomyCertified Registered Nurse Anesthetist
License Number
License Number State
# 2
Primary TaxonomyY
Taxonomy Code207L00000X
TaxonomyAnesthesiology Physician
License Number
License Number State

VIII. Authorized Official

Name: DAVID J. KRANTZ
Title or Position: VICE PRESIDENT
Credential: M.D.
Phone: 440-997-2262