| Shoreline Anesthesia, Llc | |
|
101 N Union St Unit 533 Kokomo IN 46901-5045 | |
| (718) 644-0622 | |
| Not Available |
| Full Name | Shoreline Anesthesia, Llc |
|---|---|
| Speciality | Dentist - Dentist Anesthesiologist |
| Location | 101 N Union St Unit 533, Kokomo, Indiana |
| Authorized Official Name and Position | Thomas John Schaffer (PRESIDENT) |
| Authorized Official Contact | 7186440622 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Shoreline Anesthesia, Llc 101 N Union St Unit 533 Kokomo IN 46901-5045 Ph: (718) 644-0622 | Shoreline Anesthesia, Llc 101 N Union St Unit 533 Kokomo IN 46901-5045 Ph: (718) 644-0622 |
| NPI Number | 1407445620 |
|---|---|
| Provider Enumeration Date | 01/12/2021 |
| Last Update Date | 01/12/2021 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1407445620 | NPI | - | NPPES |
| 1780052936 | Medicaid | MP |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 1223D0004X | Dentist - Dentist Anesthesiologist | (* (Not Available)) | Primary |
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