Healthcare Provider Details

I. General information

NPI: 1811554405
Provider Name (Legal Business Name): YORK COUNTY ANESTHESIA PC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 05/20/2019
Last Update Date: 05/20/2019
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

164 GLENWOOD DR
ROCK HILL SC
29732-2865
US

IV. Provider business mailing address

401 COMMERCE ST STE 600
NASHVILLE TN
37219-2518
US

V. Phone/Fax

Practice location:
  • Phone: 803-324-7607
  • Fax:
Mailing address:
  • Phone: 615-345-6900
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

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

VIII. Authorized Official

Name: TIMOTHY CORVINO
Title or Position: PRESIDENT
Credential: MD
Phone: 615-345-6900