Provider Demographics
NPI:1699055251
Name:RGAL ANESTHESIA SERVICES LLC
Entity type:Organization
Organization Name:RGAL ANESTHESIA SERVICES LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:MANAGING PHYSICIAN
Authorized Official - Prefix:DR
Authorized Official - First Name:DALE
Authorized Official - Middle Name:
Authorized Official - Last Name:WHITEBLOOM
Authorized Official - Suffix:
Authorized Official - Credentials:DO
Authorized Official - Phone:717-544-3400
Mailing Address - Street 1:2104 HARRISBURG PIKE
Mailing Address - Street 2:SUITE 300
Mailing Address - City:LANCASTER
Mailing Address - State:PA
Mailing Address - Zip Code:17601-2644
Mailing Address - Country:US
Mailing Address - Phone:717-544-3400
Mailing Address - Fax:717-544-3256
Practice Address - Street 1:2104 HARRISBURG PIKE
Practice Address - Street 2:SUITE 300
Practice Address - City:LANCASTER
Practice Address - State:PA
Practice Address - Zip Code:17601-2644
Practice Address - Country:US
Practice Address - Phone:717-544-3400
Practice Address - Fax:717-544-3256
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2011-08-26
Last Update Date:2011-08-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207L00000XAllopathic & Osteopathic PhysiciansAnesthesiologyGroup - Single Specialty