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Contact Information

THREE RIVERS ANESTHESIA, LLC
7956 W. JEFFERSON BLVD.
FORT WAYNE, IN46804
 Phone: 765-284-0493
 Fax: 765-284-2434
 Website:
 

Specialty

Taxonomy Code Specialty Code Provider Type

Anesthesiology

207L00000X 79 Physician/Addiction Medicine
Indicates primary specialty

NPI Profile & details for THREE RIVERS ANESTHESIA, LLC

NPI # 1760542468
LBN Legal business name THREE RIVERS ANESTHESIA, LLC
Authorized official MARY JENNIFER PHUONG - (OWNER)
Entity Organization
Organization subpart 1 No
Enumeration date 12/11/2006
Last updated 08/22/2020 - About 6 years ago
Identifiers n/a
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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