Basic Information
| Provider Information | |||||||||
| NPI: | 1023066859 | ||||||||
| EntityType: | 2 | ||||||||
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| OrganizationName: | OFFICE BASED ANESTHESIA SOLUTIONS, INC. | ||||||||
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| Mailing Information | |||||||||
| Address1: | PO BOX 2055 | ||||||||
| Address2: | |||||||||
| City: | CRANBERRY TOWNSHIP | ||||||||
| State: | PA | ||||||||
| PostalCode: | 160661055 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 7247728000 | ||||||||
| FaxNumber: | 7247728040 | ||||||||
| Practice Location | |||||||||
| Address1: | 20399 ROUTE 19 | ||||||||
| Address2: | ONE LANDMARK NORTH SUITE 203 | ||||||||
| City: | CRANBERRY TOWNSHIP | ||||||||
| State: | PA | ||||||||
| PostalCode: | 160666134 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 7247728000 | ||||||||
| FaxNumber: | 7247728040 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 05/04/2006 | ||||||||
| LastUpdateDate: | 08/22/2020 | ||||||||
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| AuthorizedOfficialLastName: | KUNKEL | ||||||||
| AuthorizedOfficialFirstName: | FRANK | ||||||||
| AuthorizedOfficialMiddleName: | A | ||||||||
| AuthorizedOfficialTitleorPosition: | PRESIDENT | ||||||||
| AuthorizedOfficialTelephone: | 7247728000 | ||||||||
| IsSoleProprietor: | |||||||||
| IsOrganizationSubpart: | N | ||||||||
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| AuthorizedOfficialCredential: | M. D. | ||||||||
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Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 208VP0000X | X | 193400000X MULTIPLE SINGLE SPECIALTY GROUP | Allopathic & Osteopathic Physicians | Pain Medicine | Pain Medicine | 207L00000X | X | 193400000X MULTIPLE SINGLE SPECIALTY GROUP | Allopathic & Osteopathic Physicians | Anesthesiology |
ID Information
| ID | Type | State | Issuer | Description | 142539 | 01 | PA | UNISON GROUP INSURANCE | OTHER | 3542948 | 01 | PA | AETNA GROUP INSURANCE | OTHER | 0011567400009 | 05 | PA | MEDICAID | VON386 | 01 | PA | UPMC | OTHER | 1529549 | 01 | PA | GATEWAY GROUP INSURANCE | OTHER | 2521800 | 05 | OH | MEDICAID | DA5301 | 01 | PA | RAILROAD MEDICARE GROUP | OTHER | 201731 | 01 | PA | HEALTH AMERICA | OTHER |