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NPI Code Detail

MEDICARE: COMFORT CARE ANESTHESIA LLC

MEDICARE: COMFORT CARE ANESTHESIA LLC
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1367500000XCertified Registered Nurse Anesthetist35280WV
2367500000XCertified Registered Nurse Anesthetist180984NC
3367500000XCertified Registered Nurse Anesthetist1499SC
4367500000XCertified Registered Nurse AnesthetistR143442MD

Medicare Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
2DG3055OTHERGARAILROAD MEDICARE
3469POTHERMDMEDICARE

Other Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
147TCTMOTHERMDCAREFIRST

General Provider Information

NPI Number : 1003031121
Entity Type Code : Organization
Provider Name (Legal Business Name) : COMFORT CARE ANESTHESIA LLC
Provider Business Mailing Address
First Line : 10512 TWIN CEDAR CT
Second Line :
City : LAUREL
State : MD
Zip : 20723-5721
Country : US
Telephone Number : 301-497-9944
Fax Number :
Provider Business Practice Location Address
First Line : 10512 TWIN CEDAR CT
Second Line :
City : LAUREL
State : MD
Zip : 20723-5721
Country : US
Telephone Number : 301-497-9944
Fax Number :
Authorized Official
Title or Position : CRNA
Name : MRS. TAWYANA MAE FLEMING
Credential : CRNA
Telephone Number : 301-497-9944
Provider Enumeration Date : 04/16/2007
Last Update Date : 04/01/2008

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Directions to “COMFORT CARE ANESTHESIA LLC ” Practice Location

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