Organization
TOBACCO ROOT ANESTHESIOLOGY, LLC
Active
Organization
TOBACCO ROOT ANESTHESIOLOGY, LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MARK E VANDOLAH CRNA,MAE (PRESIDENT)
(406) 285-6588
Entity
Organization
Contact information
Practice address
7 VANDOLAH RD, THREE FORKS, MT 59752-8673
(406) 285-6588
(406) 285-9012
Mailing address
PO BOX 1330, THREE FORKS, MT 59752-1330
(406) 285-6588
(406) 285-9012
Taxonomy
Speciality
Code
Description
License number
State
367500000X
Certified Registered Nurse Anesthetist
Primary
RN14372
MT
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
4308525
—
MT
Enumeration date
07/22/2006
Last updated
02/12/2014
Update your record
If you believe information in your NPPES record is inaccurate, or if you wish to update or deactivate your NPI, you can do so directly with CMS at https://nppes.cms.hhs.gov.
About Stedi
Stedi is the only programmable healthcare clearinghouse. You can use Stedi's APIs to process eligibility checks, claims, remits, and more.
Sign up