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General NPI Number Information
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NPI Number | 1477897668
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Entity Type | Organization
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Legal Business Name | OPHTHALMIC ANESTHESIA SERVICES, INC
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Dates
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Enumeration Date | 11/12/2012
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Last Update Date | 11/12/2012
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Provider Practice Location Address
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Address Line | 4800 N 22ND ST
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City | PHOENIX
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State | AZ
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Zip | 85016-4701
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Country | US
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Telephone | 602-955-1000
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Fax | 602-508-4830
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Provider Business Mailing Address
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Address Line | 4800 N 22ND ST
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City | PHOENIX
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State | AZ
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Zip | 85016-4701
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Country | US
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Telephone | 602-955-1000
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Fax | 602-508-4830
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Authorized Official
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Title or Position | SOLE OWNER
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Name | ALLAN FROMMERT
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Credential | CRNA
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Telephone | 623-332-0606
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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 |
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License Number State |
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