Organization
RED RIVER ANESTHESIA P C
Active
Organization subpart
No
Provider details
NPI number
Authorized official
ROBERT SPLICHAL C.R.N.A. (MANAGER)
(574) 268-9640
Entity
Organization
Contact information
Practice address
2400 ST FRANCIS DR, BRECKENRIDGE, MN 56520-1025
(218) 643-3000
Mailing address
PO BOX 1296, WARSAW, IN 46581-1296
(574) 268-9640
(574) 268-0684
Taxonomy
Speciality
Code
Description
License number
State
367500000X
Certified Registered Nurse Anesthetist
Primary
—
MN
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
053783700
—
MN
05
—
11090
—
ND
01
—
22L73RE
BLUE CROSS BLUE SHIELD BLUE PLUS OF MINNESOTA
MN
01
—
CG1606
PALMETTO GPA - MEDICARE RAIL ROAD
MN
01
—
CG1606
PALMETTO GPA - MEDICARE RAIL ROAD
ND
Enumeration date
08/23/2006
Last updated
11/16/2010
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