Basic Information
Provider Information
NPI: 1639176381
EntityType: 2
ReplacementNPI:  
OrganizationName: ANESTHESIA RELIEF LLC
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Mailing Information
Address1: PO BOX 1840
Address2:  
City: KAILUA KONA
State: HI
PostalCode: 967451840
CountryCode: US
TelephoneNumber: 8083256760
FaxNumber: 8084430159
Practice Location
Address1: 79-1019 HAUKAPILA ST
Address2:  
City: KEALAKEKUA
State: HI
PostalCode: 967507920
CountryCode: US
TelephoneNumber: 8083229311
FaxNumber:  
Other Information
ProviderEnumerationDate: 07/07/2005
LastUpdateDate: 01/15/2014
NPIDeactivationReasonCode:  
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AuthorizedOfficialLastName: RICK
AuthorizedOfficialFirstName: LENORE
AuthorizedOfficialMiddleName: E
AuthorizedOfficialTitleorPosition: PRESIDENT
AuthorizedOfficialTelephone: 8083256760
IsSoleProprietor:  
IsOrganizationSubpart: N
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AuthorizedOfficialCredential: CRNA
NPICertificationDate:  

Taxonomy Information
TaxonomyLicenseStateSwitchTaxonomyGroupTaxonomyTypeTaxonomyClassSubSpecialty
367500000XAPRN286HIY193400000X SINGLE SPECIALTY GROUPPhysician Assistants & Advanced Practice Nursing ProvidersNurse Anesthetist, Certified Registered 

No ID Information.


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