Organization
PREMIER ANESTHESIA ASSOCIATES
Active
Organization subpart
No
Provider details
NPI number
Authorized official
TINA RIGDON (BILLING SERVICE)
(678) 838-1585
Entity
Organization
Contact information
Practice address
330 ALCOVY ST, MONROE, GA 30655-2140
(678) 838-1585
Mailing address
PO BOX 724928, ATLANTA, GA 31139-9028
(678) 838-1585
Taxonomy
Speciality
Code
Description
License number
State
207L00000X
Anesthesiology Physician
Primary
—
—
367500000X
Certified Registered Nurse Anesthetist
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
GRP6349
MEDICARE GROUP NUMBER
—
Enumeration date
03/28/2007
Last updated
07/18/2007
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