Provider Demographics
NPI:1144348871
Name:PREMIER ANESTHESIOLOGISTS,INC
Entity type:Organization
Organization Name:PREMIER ANESTHESIOLOGISTS,INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CRNA
Authorized Official - Prefix:
Authorized Official - First Name:PATRICIA
Authorized Official - Middle Name:ANN
Authorized Official - Last Name:HILE
Authorized Official - Suffix:
Authorized Official - Credentials:CRNA
Authorized Official - Phone:614-451-0500
Mailing Address - Street 1:1635 KEATS CT
Mailing Address - Street 2:
Mailing Address - City:COLUMBUS
Mailing Address - State:OH
Mailing Address - Zip Code:43235-1122
Mailing Address - Country:US
Mailing Address - Phone:614-785-9810
Mailing Address - Fax:
Practice Address - Street 1:930 BETHEL RD
Practice Address - Street 2:
Practice Address - City:COLUMBUS
Practice Address - State:OH
Practice Address - Zip Code:43214-1906
Practice Address - Country:US
Practice Address - Phone:614-451-0500
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-03-27
Last Update Date:2007-07-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OHRN-220785261QA1903X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QA1903XAmbulatory Health Care FacilitiesClinic/CenterAmbulatory Surgical
Provider Identifiers
StateIdentifier IDID TypeIssuer
OH8221332Medicare ID - Type Unspecified