MEDICARE: ROMERO ANESTHESIA INC

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
1	367500000X	Certified Registered Nurse Anesthetist

General Provider Information

NPI Number	:	1144693946
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	ROMERO ANESTHESIA INC

Provider Business Mailing Address
First Line	:	8088 CHINKAPIN CT
Second Line	:
City	:	OOLTEWAH
State	:	TN
Zip	:	37363-7187
Country	:	US
Telephone Number	:	423-994-9120
Fax Number	:	423-424-3690

Provider Business Practice Location Address
First Line	:	1405 COWART ST
Second Line	:	STE 201
City	:	CHATTANOOGA
State	:	TN
Zip	:	37408-1127
Country	:	US
Telephone Number	:	423-758-8367
Fax Number	:

Authorized Official
Title or Position	:	OWNER
Name	:	ALBERT ROMERO
Credential	:	CRNA
Telephone Number	:	423-994-9120

Provider Enumeration Date	:	11/03/2015
Last Update Date	:	11/03/2015

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