Provider Demographics
NPI:1538173844
Name:VW ANESTHESIA, INC.
Entity type:Organization
Organization Name:VW ANESTHESIA, INC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:DUANE
Authorized Official - Middle Name:L
Authorized Official - Last Name:FUERST
Authorized Official - Suffix:
Authorized Official - Credentials:CRNA
Authorized Official - Phone:419-232-2866
Mailing Address - Street 1:140 FOX RD
Mailing Address - Street 2:SUITE 207
Mailing Address - City:VAN WERT
Mailing Address - State:OH
Mailing Address - Zip Code:45891-2475
Mailing Address - Country:US
Mailing Address - Phone:419-232-2866
Mailing Address - Fax:419-232-2867
Practice Address - Street 1:140 FOX RD
Practice Address - Street 2:SUITE 207
Practice Address - City:VAN WERT
Practice Address - State:OH
Practice Address - Zip Code:45891-2475
Practice Address - Country:US
Practice Address - Phone:419-232-2866
Practice Address - Fax:419-232-2867
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-07-29
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OHRN147379251J00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251J00000XAgenciesNursing Care
Provider Identifiers
StateIdentifier IDID TypeIssuer
OH000000249722OtherANTHEM BC/BS
OH43007320OtherMEDICARE RAILROAD
OH0487638Medicaid
OH=========OtherCHAMPUS/TRICARE CORP
OH=========00OtherWORKMENS COMP
OH0487638Medicaid
OH=========OtherCHAMPUS/TRICARE CORP