Organization
ASAG, INC.
Active
Other names
Ambulatory Surgery Anesthesia Group. Inc.
Organization subpart
No
Provider details
NPI number
Authorized official
MRS. PAULA N STORK CRNA (CRNA)
(870) 435-4477
Entity
Organization
Contact information
Practice address
160 HWY 201 NORTH, MOUNTAIN HOME, AR 72653
(870) 508-2100
(870) 508-2150
Mailing address
PO BOX 434, GASSVILLE, AR 72635-0434
(870) 435-4477
Taxonomy
Speciality
Code
Description
License number
State
367500000X
Certified Registered Nurse Anesthetist
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
5F724
MEDICARE PROVIDER NUMBER
AR
Enumeration date
02/26/2007
Last updated
08/31/2007
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