# ANESTHESIA INTENSIVE CARE LLC

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- **Entity:** Organization
- **Status:** Active
- **Organization subpart:** No

## Provider details

- **NPI number:** 1508387382
- **Authorized official:** SHIRA BLACK D.O. (OWNER)
- **Authorized official phone:** (563) 324-8160

## Contact information

- **Practice address:** 1227 E RUSHOLME ST, DAVENPORT, IA 52803-2459
- **Practice address phone:** (563) 421-1000
- **Mailing address:** PO BOX 2490, DAVENPORT, IA 52809-2490

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 207LC0200X | Critical Care Medicine (Anesthesiology) Physician | — | NULL | Yes |
| 207LC0200X | Critical Care Medicine (Anesthesiology) Physician | — | — | Yes |

## Other

- **Enumeration date:** 06/30/2017
- **Last updated:** 06/30/2017