Organization
PEDIATRIC ANAESTHESIA ASSOCIATES, PSC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. WALTER M ROSE D.O. (DIRECTOR)
(502) 451-9949
Entity
Organization
Contact information
Practice address
231 E CHESTNUT ST, KOSAIR CHILDRENS HOSPITAL, LOUISVILLE, KY 40202-1821
(502) 451-9949
(502) 451-4553
Mailing address
DEPARTMENT 5090, PO BOX 740041, LOUISVILLE, KY 40201-7441
(502) 451-9949
(502) 451-4553
Taxonomy
Speciality
Code
Description
License number
State
207L00000X
Anesthesiology Physician
Primary
—
—
207LP3000X
Pediatric Anesthesiology Physician
—
—
367500000X
Certified Registered Nurse Anesthetist
—
KY
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
65914699
—
KY
Enumeration date
09/05/2006
Last updated
11/24/2015
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