Basic Information
| Provider Information | |||||||||
| NPI: | 1811554405 | ||||||||
| EntityType: | 2 | ||||||||
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| OrganizationName: | YORK COUNTY ANESTHESIA PC | ||||||||
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| Mailing Information | |||||||||
| Address1: | 401 COMMERCE ST STE 600 | ||||||||
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| City: | NASHVILLE | ||||||||
| State: | TN | ||||||||
| PostalCode: | 372192518 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 6153456900 | ||||||||
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| Practice Location | |||||||||
| Address1: | 164 GLENWOOD DR | ||||||||
| Address2: | |||||||||
| City: | ROCK HILL | ||||||||
| State: | SC | ||||||||
| PostalCode: | 297322865 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 8033247607 | ||||||||
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| Other Information | |||||||||
| ProviderEnumerationDate: | 05/20/2019 | ||||||||
| LastUpdateDate: | 05/20/2019 | ||||||||
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| AuthorizedOfficialLastName: | CORVINO | ||||||||
| AuthorizedOfficialFirstName: | TIMOTHY | ||||||||
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| AuthorizedOfficialTitleorPosition: | PRESIDENT | ||||||||
| AuthorizedOfficialTelephone: | 6153456900 | ||||||||
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| IsOrganizationSubpart: | N | ||||||||
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| AuthorizedOfficialCredential: | MD | ||||||||
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Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 367500000X | N | 193200000X MULTI-SPECIALTY GROUP | Physician Assistants & Advanced Practice Nursing Providers | Nurse Anesthetist, Certified Registered | 207L00000X | Y | 193200000X MULTI-SPECIALTY GROUP | Allopathic & Osteopathic Physicians | Anesthesiology |
No ID Information.