Organization
TOTAL ANESTHESIA CARE STPH, LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
SHAN MCDANIEL AND SANDRA DIPIETRO (COO & CFO)
(985) 892-3225
Entity
Organization
Contact information
Practice address
1202 S TYLER ST, COVINGTON, LA 70433-2330
(985) 898-4000
Mailing address
120 INNWOOD DR, COVINGTON, LA 70433-9123
(985) 892-3225
(985) 234-0628
Taxonomy
Speciality
Code
Description
License number
State
207L00000X
Anesthesiology Physician
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
09016177
—
MS
05
—
1441759
—
LA
Enumeration date
05/30/2005
Last updated
09/18/2020
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