Healthcare Provider Details

I. General information

NPI: 1235229501
Provider Name (Legal Business Name): PINCH ANESTHESIA ASSOCIATES,INC.
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 10/14/2006
Last Update Date: 09/23/2008
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

11 GRAYSTONE EST
ELKVIEW WV
25071-9400
US

IV. Provider business mailing address

11 GRAYSTONE EST
ELKVIEW WV
25071-9400
US

V. Phone/Fax

Practice location:
  • Phone: 304-965-7728
  • Fax: 304-965-7728
Mailing address:
  • Phone: 304-965-7728
  • Fax: 304-965-7728

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code282N00000X
TaxonomyGeneral Acute Care Hospital
License Number18008
License Number StateWV

VIII. Authorized Official

Name: MR. CARL ALBERT WHEELER
Title or Position: PRESIDENT
Credential: C.R.N.A.
Phone: 304-965-7728