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Contact Information

ROGUE ANESTHESIA LLC
1601 NW HAWTHORNE AVE
GRANTS PASS, OR97526
 Phone: 541-472-4884
 Fax:
 Website:
 

Specialty

Taxonomy Code Specialty Code Provider Type

Anesthesiology

207L00000X 79 Physician/Addiction Medicine
Indicates primary specialty

NPI Profile & details for ROGUE ANESTHESIA LLC

NPI # 1043248917
LBN Legal business name ROGUE ANESTHESIA LLC
Authorized official ROBERT MONTGOMERY - (MANAGER)
Entity Organization
Organization subpart 1 No
Enumeration date 06/29/2006
Last updated 11/01/2010 - About 16 years ago
Identifiers
OR License # MD18872
OR Medicaid 130351
OR Other 023807000 REGENCE BCBSO
1 Some organization health care providers are made up of components that furnish different types of health care or have separate physical locations where health care is furnished. These components and physical locations are not themselves legal entities, but are part of the organization health care provider (which is a legal entity). A covered organization provider may decide that its subparts (if it has any) should have their own NPI numbers. If a subpart conducts any HIPAA standard transactions on its own (e.g., separately from its parent), it must obtain its own NPI number.

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