Organization
DOMINICK 'S ANESTHESIA SERVICE INC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MR. DOMINICK PETER PALMISANO C.R.N.A. (PRESIDENT)
(918) 260-9749
Entity
Organization
Contact information
Practice address
17781 S.543 ROAD, TAHLEQUAH, OK 74464-2000
(918) 207-0727
Mailing address
P.O.BOX 398, TAHLEQUAH, OK 74465-0398
(918) 260-9749
Taxonomy
Speciality
Code
Description
License number
State
282NR1301X
Rural Acute Care Hospital
Primary
ROO49310
OK
Other
Enumeration date
10/18/2006
Last updated
08/22/2020
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