Basic Information
| Provider Information | |||||||||
| NPI: | 1215654553 | ||||||||
| EntityType: | 2 | ||||||||
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| OrganizationName: | SAFE & SOUND ANESTHESIA SERVICES LLC | ||||||||
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| Mailing Information | |||||||||
| Address1: | 661 LICK BRANCH RD | ||||||||
| Address2: | |||||||||
| City: | CHARLESTON | ||||||||
| State: | WV | ||||||||
| PostalCode: | 253126761 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 3042080707 | ||||||||
| FaxNumber: | 8007589795 | ||||||||
| Practice Location | |||||||||
| Address1: | 84 BROOKSHIRE LN | ||||||||
| Address2: | |||||||||
| City: | BECKLEY | ||||||||
| State: | WV | ||||||||
| PostalCode: | 258016765 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 3042552724 | ||||||||
| FaxNumber: | 8007589795 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 10/27/2022 | ||||||||
| LastUpdateDate: | 11/07/2022 | ||||||||
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| AuthorizedOfficialLastName: | BOSTIC | ||||||||
| AuthorizedOfficialFirstName: | LORETTA | ||||||||
| AuthorizedOfficialMiddleName: | ANN | ||||||||
| AuthorizedOfficialTitleorPosition: | MANAGING MEMBER | ||||||||
| AuthorizedOfficialTelephone: | 3042080707 | ||||||||
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| IsOrganizationSubpart: | N | ||||||||
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| AuthorizedOfficialCredential: | DNP, APRN, CRNA | ||||||||
| NPICertificationDate: | 11/07/2022 | ||||||||
Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 367500000X | Y | 193400000X SINGLE SPECIALTY GROUP | Physician Assistants & Advanced Practice Nursing Providers | Nurse Anesthetist, Certified Registered |
No ID Information.