MEDICARE: FRSC 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
1	207L00000X	Anesthesiology Physician

General Provider Information

NPI Number	:	1316661275
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	FRSC ANESTHESIA LLC

Provider Business Mailing Address
First Line	:	2701 W NORFOLK AVE STE 101
Second Line	:
City	:	NORFOLK
State	:	NE
Zip	:	68701-4408
Country	:	US
Telephone Number	:	402-644-7262
Fax Number	:

Provider Business Practice Location Address
First Line	:	2701 W NORFOLK AVE STE 101
Second Line	:
City	:	NORFOLK
State	:	NE
Zip	:	68701-4408
Country	:	US
Telephone Number	:	402-644-7262
Fax Number	:

Authorized Official
Title or Position	:	OWNER
Name	:	TRISTAN HARTZELL
Credential	:	MD
Telephone Number	:	402-644-7262

Provider Enumeration Date	:	10/03/2022
Last Update Date	:	10/03/2022

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Directions to “FRSC ANESTHESIA LLC ” Practice Location

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