Provider Demographics
NPI:1386887271
Name:TRISTATE ANESTHESIA SOLUTIONS LLC
Entity type:Organization
Organization Name:TRISTATE ANESTHESIA SOLUTIONS LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:LISA
Authorized Official - Middle Name:
Authorized Official - Last Name:VOLPITTO
Authorized Official - Suffix:
Authorized Official - Credentials:CRNA
Authorized Official - Phone:706-288-6358
Mailing Address - Street 1:13 INDIAN COVE RD
Mailing Address - Street 2:
Mailing Address - City:AUGUSTA
Mailing Address - State:GA
Mailing Address - Zip Code:30909-3746
Mailing Address - Country:US
Mailing Address - Phone:706-288-6358
Mailing Address - Fax:706-210-0771
Practice Address - Street 1:447 N BELAIR RD
Practice Address - Street 2:SUITE 103
Practice Address - City:EVANS
Practice Address - State:GA
Practice Address - Zip Code:30809-3090
Practice Address - Country:US
Practice Address - Phone:706-854-3333
Practice Address - Fax:706-210-0771
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2009-04-08
Last Update Date:2009-04-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
207L00000X
GARN093483367500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes367500000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse Anesthetist, Certified RegisteredGroup - Multi-Specialty
No207L00000XAllopathic & Osteopathic PhysiciansAnesthesiologyGroup - Multi-Specialty