Basic Information
Provider Information
NPI: 1124455753
EntityType: 2
ReplacementNPI:  
OrganizationName: ALBION ANESTHESIA LLC
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Mailing Information
Address1: PO BOX 3810
Address2:  
City: SALT LAKE CITY
State: UT
PostalCode: 841103810
CountryCode: US
TelephoneNumber: 8883331095
FaxNumber: 8015427372
Practice Location
Address1: 1050 E SOUTH TEMPLE
Address2:  
City: SALT LAKE CITY
State: UT
PostalCode: 841021507
CountryCode: US
TelephoneNumber: 8013504700
FaxNumber:  
Other Information
ProviderEnumerationDate: 09/27/2013
LastUpdateDate: 09/27/2013
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AuthorizedOfficialLastName: HOWARD
AuthorizedOfficialFirstName: BEN
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AuthorizedOfficialTitleorPosition: PRESIDENT
AuthorizedOfficialTelephone: 8013504700
IsSoleProprietor:  
IsOrganizationSubpart: N
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AuthorizedOfficialCredential: DO
NPICertificationDate:  

Taxonomy Information
TaxonomyLicenseStateSwitchTaxonomyGroupTaxonomyTypeTaxonomyClassSubSpecialty
207L00000X  Y193200000X MULTI-SPECIALTY GROUPAllopathic & Osteopathic PhysiciansAnesthesiology 

No ID Information.


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