| Organization Name: | SHADOW ANESTHESIA SERVICES, LLC |
| NPI Number: | 1871807206 |
| Entity Type Code: | Organizational (2) |
| Authorized Official Name: | HOLLY VICTORIA LASHMET (OWNER) |
| Mailing Address: | 23030 N Rd Holton |
| State: | KS US |
| Postal Code: | 664368600 |
| Phone Number: | 9705805191 |
| Fax Number: | 7853643909 |
| NPI Enumeration Date: | 07/27/2010 |
| NPI Last Update Date: | 07/27/2010 |
| Replacement NPI: | 0 |
| NPI Deactivation Date: | |
| NPI Reactivation Date: |
Taxonomy Information: | |
| Healthcare Provider Taxonomy: | 261QA1903X |
| License Number: | 55417 |
| Healthcare Provider Taxonomy: (Secondary) | N |
| State: | KS |
| Taxonomy Type: | Ambulatory Health Care Facilities |
| Taxonomy Classification: | Clinic/Center |
| Taxonomy Specialization: | Ambulatory Surgical |
| Taxonomy Definition: | |