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General NPI Number Information
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NPI Number | 1306917398
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Entity Type | Organization
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Legal Business Name | GROVES ANSELM ANESTHESIA SERVICES INC
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Dates
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Enumeration Date | 11/13/2006
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Last Update Date | 08/22/2020
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Provider Practice Location Address
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Address Line | 970 EAST WASHINGTON AVE SUITE 203 MEDINA SURGICAL HOSPITAL
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City | MEDINA
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State | OH
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Zip | 44256
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Country | US
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Telephone | 330-723-7246
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Fax | 330-725-7855
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Provider Business Mailing Address
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Address Line | PO BOX 335
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City | BATH
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State | OH
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Zip | 44210
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Country | US
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Telephone | 330-472-5249
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Fax |
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Authorized Official
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Title or Position | PRESIDENT
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Name | ROBIN LEE GROVES ANSELM
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Credential | CRNA
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Telephone | 330-665-0758
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 367500000X
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Taxonomy Name | Certified Registered Nurse Anesthetist
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License Number | AANA45193
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License Number State | OH
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