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General NPI Number Information
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NPI Number | 1346851276
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Entity Type | Organization
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Legal Business Name | GALAXY ANESTHESIA SERVICES, LLC
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Dates
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Enumeration Date | 08/13/2020
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Last Update Date | 08/13/2020
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Provider Practice Location Address
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Address Line | 13660 N 94TH DR D-1
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City | PEORIA
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State | AZ
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Zip | 85381-8538
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Country | US
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Telephone | 623-230-2912
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Fax | 602-726-3605
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Provider Business Mailing Address
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Address Line | 7558 W THUNDERBIRD RD SUITE 1-623
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City | PEORIA
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State | AZ
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Zip | 85381-4836
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Country | US
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Telephone | 623-230-2912
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Fax |
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Authorized Official
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Title or Position | MANAGER
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Name | KEITH BANGART
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Credential | DPM
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Telephone | 623-230-2912
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 207LP2900X
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Taxonomy Name | Pain Medicine (Anesthesiology) Physician
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License Number |
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License Number State |
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Taxonomy #2
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Taxonomy Code | 207LP3000X
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Taxonomy Name | Pediatric Anesthesiology Physician
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License Number |
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License Number State |
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Taxonomy #3
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Taxonomy Code | 207L00000X
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Taxonomy Name | Anesthesiology Physician
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License Number |
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License Number State |
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