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General NPI Number Information
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NPI Number | 1740395011
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Entity Type | Organization
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Legal Business Name | CENTRAL ANESTHESIA LLC
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Dates
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Enumeration Date | 08/20/2006
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Last Update Date | 12/05/2011
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Provider Practice Location Address
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Address Line | 187 HOSPITAL DR
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City | TYRONE
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State | PA
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Zip | 16686-1808
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Country | US
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Telephone | 814-684-6374
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Fax | 814-684-6320
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Provider Business Mailing Address
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Address Line | PO BOX 265
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City | MARTINSBURG
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State | PA
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Zip | 16662
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Country | US
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Telephone | 814-793-4833
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Fax | 814-793-4834
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Authorized Official
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Title or Position | CEO
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Name | DR. JOHN H JOHNSON
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Credential | MD
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Telephone | 814-684-6374
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 174400000X
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Taxonomy Name | Specialist
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License Number | MD044867E
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License Number State | PA
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Taxonomy #2
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Taxonomy Code | 208VP0000X
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Taxonomy Name | Pain Medicine Physician
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License Number | MD044867E
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License Number State | PA
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