Healthcare Provider Details

I. General information

NPI: 1538173844
Provider Name (Legal Business Name): VW ANESTHESIA, INC.
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 07/29/2006
Last Update Date: 08/22/2020
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

140 FOX RD SUITE 207
VAN WERT OH
45891-2475
US

IV. Provider business mailing address

140 FOX RD SUITE 207
VAN WERT OH
45891-2475
US

V. Phone/Fax

Practice location:
  • Phone: 419-232-2866
  • Fax: 419-232-2867
Mailing address:
  • Phone: 419-232-2866
  • Fax: 419-232-2867

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code251J00000X
TaxonomyNursing Care Agency
License NumberRN147379
License Number StateOH

VIII. Authorized Official

Name: DUANE L FUERST
Title or Position: PRESIDENT
Credential: CRNA
Phone: 419-232-2866