Healthcare Provider Details
I. General information
NPI: 1114193463
Provider Name (Legal Business Name): ANESTHESIA & INTENSIVE CARE CONSULTANTS, INC.
Entity Type: Organization
Gender:
Sole Proprietor:
II. Dates (important events)
Enumeration Date: 05/07/2008
Last Update Date: 07/18/2013
Certification Date:
Deactivation Date:
Reactivation Date:
III. Provider practice location address
7500 STATE RD
CINCINNATI OH
45255-2439
US
IV. Provider business mailing address
20 MEDICAL VILLAGE DR SUITE 258
EDGEWOOD KY
41017-5401
US
V. Phone/Fax
- Phone: 859-341-7246
- Fax: 859-341-7867
- Phone: 859-341-7246
- Fax: 859-341-7867
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: DR.
LEE
S
MEGOIS
Title or Position: MEDICAL DIRECTOR
Credential: MD
Phone: 859-341-7246