Basic Information
| Provider Information | |||||||||
| NPI: | 1063482107 | ||||||||
| EntityType: | 2 | ||||||||
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| OrganizationName: | PIEDMONT HENDERSONVILLE ANESTHESIA CONSULTANTS PLLC | ||||||||
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| Mailing Information | |||||||||
| Address1: | PO BOX 75220 | ||||||||
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| City: | CHARLOTTE | ||||||||
| State: | NC | ||||||||
| PostalCode: | 282750220 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 8286974330 | ||||||||
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| Practice Location | |||||||||
| Address1: | 800 N JUSTICE ST | ||||||||
| Address2: | ANESTHESIA DEPT | ||||||||
| City: | HENDERSONVILLE | ||||||||
| State: | NC | ||||||||
| PostalCode: | 287913410 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 8286961000 | ||||||||
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| Other Information | |||||||||
| ProviderEnumerationDate: | 01/23/2006 | ||||||||
| LastUpdateDate: | 07/21/2022 | ||||||||
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| AuthorizedOfficialLastName: | ZAHN | ||||||||
| AuthorizedOfficialFirstName: | ROLAND | ||||||||
| AuthorizedOfficialMiddleName: | M | ||||||||
| AuthorizedOfficialTitleorPosition: | PRESIDENT | ||||||||
| AuthorizedOfficialTelephone: | 8286974330 | ||||||||
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| IsOrganizationSubpart: | N | ||||||||
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Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 207LP2900X | NC | N | 193200000X MULTI-SPECIALTY GROUP | Allopathic & Osteopathic Physicians | Anesthesiology | Pain Medicine | 207L00000X | NC | Y | 193200000X MULTI-SPECIALTY GROUP | Allopathic & Osteopathic Physicians | Anesthesiology |
ID Information
| ID | Type | State | Issuer | Description | 890238X | 05 | NC | MEDICAID |