Organization
BEECHMONT ANESTHESIA
Active
Organization subpart
No
Provider details
NPI number
Authorized official
RENEE STROUP (BILLING CREDENTIALING MANAGER)
(570) 501-6863
Entity
Organization
Contact information
Practice address
50 MOISEY DRIVE, SUITE 204, HAZLETON, PA 18202
(570) 501-6860
(570) 501-6869
Mailing address
PO BOX 70, MOUNTAIN TOP, PA 18707
(570) 501-6860
(570) 501-6869
Taxonomy
Speciality
Code
Description
License number
State
207L00000X
Anesthesiology Physician
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1013091350001
—
PA
Enumeration date
05/18/2006
Last updated
05/01/2008
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