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General NPI Number Information
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NPI Number | 1700100419
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Entity Type | Organization
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Legal Business Name | SOUTH CENTRAL OHIO ANESTHESIA LLC
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Dates
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Enumeration Date | 03/24/2010
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Last Update Date | 10/15/2025
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Provider Practice Location Address
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Address Line | 601 STATE ROUTE 664 N
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City | LOGAN
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State | OH
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Zip | 43138-8541
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Country | US
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Telephone | 740-983-0397
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Fax |
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Provider Business Mailing Address
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Address Line | 300 DAVE COWENS DR STE 600
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City | NEWPORT
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State | KY
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Zip | 41071-4543
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Country | US
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Telephone | 859-655-8554
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Fax |
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Authorized Official
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Title or Position | DELEGATED OFFICIAL
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Name | ZACH VORST
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Credential | CRNA
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Telephone | 419-615-9373
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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 | COA.02437-NA
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License Number State | OH
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