Provider Demographics
NPI:1487157731
Name:PRIME ANESTHESIA ASSOCIATES PC
Entity type:Organization
Organization Name:PRIME ANESTHESIA ASSOCIATES PC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:AUTHORIZED OFFICIAL
Authorized Official - Prefix:
Authorized Official - First Name:ROBERT
Authorized Official - Middle Name:A
Authorized Official - Last Name:GARVIN
Authorized Official - Suffix:
Authorized Official - Credentials:DO
Authorized Official - Phone:717-431-2368
Mailing Address - Street 1:PO BOX 8230
Mailing Address - Street 2:
Mailing Address - City:LANCASTER
Mailing Address - State:PA
Mailing Address - Zip Code:17604-8230
Mailing Address - Country:US
Mailing Address - Phone:888-601-0675
Mailing Address - Fax:
Practice Address - Street 1:810 PLAZA BLVD STE 101
Practice Address - Street 2:
Practice Address - City:LANCASTER
Practice Address - State:PA
Practice Address - Zip Code:17601-2762
Practice Address - Country:US
Practice Address - Phone:717-431-2368
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2018-03-13
Last Update Date:2024-02-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207L00000XAllopathic & Osteopathic PhysiciansAnesthesiologyGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
PAPENDINGOtherMEDICARE