Organization
TANDEM ANESTHESIA LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
SEAN HINTZ CRNA (PRESIDENT)
(847) 615-2200
Entity
Organization
Contact information
Practice address
445 ASHLEY RIDGE BLVD, SHREVEPORT, LA 71106-7229
(847) 615-2200
(847) 615-2858
Mailing address
PO BOX 757, BENTON, LA 71006-0757
(847) 615-2200
(847) 615-2858
Taxonomy
Speciality
Code
Description
License number
State
367500000X
Certified Registered Nurse Anesthetist
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1449512
—
LA
01
—
721479750
BCBS OF LOUISIANA
LA
Enumeration date
09/01/2006
Last updated
06/25/2008
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