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Organization

MISSION COMMUNITY ANESTHESIOLOGY SPECIALISTS LLC

Active
Parent organization
MISSION COMMUNITY ANESTHESIOLOGY SPECIALISTS LLC
Other names
Oncology
Organization subpart
Yes

Provider details

NPI number
Legal business name
MISSION COMMUNITY ANESTHESIOLOGY SPECIALISTS LLC
Authorized official
MARILYN TATHAM (PROVIDER ENROLLMENT MANAGER)
(828) 651-6595
Entity
Organization

Contact information

Practice address
100 RIDGEFIELD CT, ASHEVILLE, NC 28806-2270
(828) 213-1740
Mailing address
PO BOX 603366, CHARLOTTE, NC 28260-3366
(828) 213-1500
(828) 681-1575

Taxonomy

Speciality
Code
Description
License number
State
207RX0202X
Medical Oncology Physician
Primary

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
02CG9
BC/BS NC
NC
Enumeration date
11/29/2018
Last updated
12/03/2018
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