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General NPI Number Information
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NPI Number | 1699055251
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Entity Type | Organization
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Legal Business Name | RGAL ANESTHESIA SERVICES LLC
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Dates
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Enumeration Date | 08/26/2011
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Last Update Date | 08/26/2011
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Provider Practice Location Address
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Address Line | 2104 HARRISBURG PIKE SUITE 300
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City | LANCASTER
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State | PA
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Zip | 17601-2644
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Country | US
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Telephone | 717-544-3400
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Fax | 717-544-3256
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Provider Business Mailing Address
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Address Line | 2104 HARRISBURG PIKE SUITE 300
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City | LANCASTER
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State | PA
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Zip | 17601-2644
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Country | US
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Telephone | 717-544-3400
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Fax | 717-544-3256
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Authorized Official
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Title or Position | MANAGING PHYSICIAN
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Name | DR. DALE WHITEBLOOM
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Credential | D.O.
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Telephone | 717-544-3400
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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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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