Provider Demographics
NPI:1972820017
Name:PAIN TREATMENT AND ANESTHESIA MANAGEMENT SERVICES, LLC
Entity type:Organization
Organization Name:PAIN TREATMENT AND ANESTHESIA MANAGEMENT SERVICES, LLC
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:AUTHORIZED OFFICIAL
Authorized Official - Prefix:
Authorized Official - First Name:TAMMY
Authorized Official - Middle Name:
Authorized Official - Last Name:PHILLIPS
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:302-598-9139
Mailing Address - Street 1:PO BOX 347
Mailing Address - Street 2:
Mailing Address - City:SAINT GEORGES
Mailing Address - State:DE
Mailing Address - Zip Code:19733-0347
Mailing Address - Country:US
Mailing Address - Phone:302-733-7271
Mailing Address - Fax:302-709-2401
Practice Address - Street 1:400 HEALTH SERVICES DR STE 401
Practice Address - Street 2:
Practice Address - City:SEAFORD
Practice Address - State:DE
Practice Address - Zip Code:19973
Practice Address - Country:US
Practice Address - Phone:302-536-6094
Practice Address - Fax:302-990-3081
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2010-04-29
Last Update Date:2018-05-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207L00000XAllopathic & Osteopathic PhysiciansAnesthesiologyGroup - Multi-Specialty
No208VP0000XAllopathic & Osteopathic PhysiciansPain MedicinePain MedicineGroup - Multi-Specialty
No208VP0014XAllopathic & Osteopathic PhysiciansPain MedicineInterventional Pain MedicineGroup - Multi-Specialty