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General NPI Number Information
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NPI Number | 1821452509
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Entity Type | Organization
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Legal Business Name | PINNACLE ANESTHESIA SERVICES ASPEN MOUNTAIN LLC
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Dates
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Enumeration Date | 04/08/2016
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Last Update Date | 04/08/2016
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Provider Practice Location Address
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Address Line | 4401 COLLEGE DR
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City | ROCK SPRINGS
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State | WY
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Zip | 82901-3507
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Country | US
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Telephone | 307-352-8900
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Fax | 307-352-8901
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Provider Business Mailing Address
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Address Line | PO BOX 2378
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City | DURANGO
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State | CO
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Zip | 81302-2378
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Country | US
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Telephone | 970-375-1550
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Fax |
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Authorized Official
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Title or Position | OWNER
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Name | DR. RANDALL B RICE
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Credential | M.D.
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Telephone | 970-749-3238
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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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