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MARYVILLE MEDICAL SERVICES LLC NPI 1780614669


NPI Information

NPI: 1780614669
Provider Name: MARYVILLE MEDICAL SERVICES, LLC
Classification: Nurse Anesthetist, Certified Registered - 367500000X
Entity Type: Organization
Address:
6810 STATE ROUTE 162
SUITE 215
MARYVILLE, IL
ZIP 62062
Phone: (618) 288-5711
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MARYVILLE MEDICAL SERVICES, LLC is a nurse anesthetist certified registered in Maryville, IL. The provider is (1) A licensed registered nurse with advanced specialty education in anesthesia who, in collaboration with appropriate health care professionals, provides preoperative, intraoperative, and postoperative care to patients and assists in management and resuscitation of critical patients in intensive care, coronary care, and emergency situations. Nurse anesthetists are certified following successful completion of credentials and state licensure review and a national examination directed by the Council on Certification of Nurse Anesthetists. (2) A registered nurse who is qualified by special training to administer anesthesia in collaboration with a physician or dentist and who can assist in the care of patients who are in critical condition. MARYVILLE MEDICAL SERVICES, LLC NPI is 1780614669. The provider is registered as an organization entity type and is a multi-specialty group.

The provider's business location address is:

6810 STATE ROUTE 162
SUITE 215
MARYVILLE, IL
ZIP 62062-501
Phone: (618) 288-5711
Fax: (618) 288-4088

The provider's authorized official is Keith Page .
The authorized official title is Ceo and has the following contact phone number (618) 288-5711.

The enumeration date for this NPI number is 7/4/2006 and was last updated on 6/23/2008.


Taxonomy Codes

The NPI record includes the healthcare provider taxonomy classification, state license number and state of licensure. The following information regarding the scope of practice of this provider is available:

No. Taxonomy Code Taxonomy Clasification Taxonomy Specialization License Number License State Primary
1103T00000XPsychologistNo
2367500000XNurse Anesthetist, Certified RegisteredYes

Other Identifiers

The following information regarding additional identifiers associated to this NPI record includes the other identifier number, identifier type, identifier state and issuer.

No. Other Provider Identifier Other Provider Identifier Type Other Provider Identifier State Other Provider Identifier Issuer
1208901MEDICARE ID-TYPE UNSPECIFIEDILLINOISGROUP MEDICARE NUMBER

What is NPI?

NPI stands for National Provider Identifier. The NPI is a 10-digit identification number that is completely unique. The NPI number by itself does not contain any identifiable information such as a provider’s speciality or location. The NPI is assigned to individuals or organizacions for their lifespan and it is independent of key provider information type updates like a change of practices, location or speciality.

This page was last updated on: 5/5/2024

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