Basic Information
| Provider Information | |||||||||
| NPI: | 1245685601 | ||||||||
| EntityType: | 2 | ||||||||
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| OrganizationName: | AIM ANESTHESIA LLC | ||||||||
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| Mailing Information | |||||||||
| Address1: | 2 CLAYTON COURT DR | ||||||||
| Address2: | |||||||||
| City: | FRONTENAC | ||||||||
| State: | MO | ||||||||
| PostalCode: | 631312524 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 6189756206 | ||||||||
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| Practice Location | |||||||||
| Address1: | 3550 MCKELVEY ROAD | ||||||||
| Address2: | PREMIER SURGERY CENTER | ||||||||
| City: | BRIDGETOWN | ||||||||
| State: | MO | ||||||||
| PostalCode: | 63044 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 3147410911 | ||||||||
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| Other Information | |||||||||
| ProviderEnumerationDate: | 05/04/2016 | ||||||||
| LastUpdateDate: | 05/04/2016 | ||||||||
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| AuthorizedOfficialLastName: | MAHAY | ||||||||
| AuthorizedOfficialFirstName: | RINKI | ||||||||
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| AuthorizedOfficialTitleorPosition: | ANESTHESIOLOGIST | ||||||||
| AuthorizedOfficialTelephone: | 6189756206 | ||||||||
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| IsOrganizationSubpart: | N | ||||||||
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| AuthorizedOfficialNamePrefix: | MRS. | ||||||||
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| AuthorizedOfficialCredential: | MD | ||||||||
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Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 207L00000X | 2013030320 | MO | Y | 193400000X SINGLE SPECIALTY GROUP | Allopathic & Osteopathic Physicians | Anesthesiology |
No ID Information.