Basic Information
| Provider Information | |||||||||
| NPI: | 1881828184 | ||||||||
| EntityType: | 2 | ||||||||
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| OrganizationName: | PALMETTO ANESTHESIA SERVICES OF AIKEN, LLC | ||||||||
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| Mailing Information | |||||||||
| Address1: | 806 OLEANDER DR SE | ||||||||
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| City: | AIKEN | ||||||||
| State: | SC | ||||||||
| PostalCode: | 298015166 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 8036482840 | ||||||||
| FaxNumber: | 3365533994 | ||||||||
| Practice Location | |||||||||
| Address1: | 4211 TROLLEY LINE RD | ||||||||
| Address2: | DEPT OF ANESTHESIA | ||||||||
| City: | AIKEN | ||||||||
| State: | SC | ||||||||
| PostalCode: | 298012749 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 8036482840 | ||||||||
| FaxNumber: | 3365533994 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 05/14/2009 | ||||||||
| LastUpdateDate: | 05/14/2009 | ||||||||
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| AuthorizedOfficialLastName: | HINER | ||||||||
| AuthorizedOfficialFirstName: | ERIC | ||||||||
| AuthorizedOfficialMiddleName: | A | ||||||||
| AuthorizedOfficialTitleorPosition: | PRESIDENT | ||||||||
| AuthorizedOfficialTelephone: | 8036482840 | ||||||||
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| IsOrganizationSubpart: | N | ||||||||
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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.