Provider Demographics
NPI:1174750673
Name:PAIN CENTERS OF AMERICA
Entity type:Organization
Organization Name:PAIN CENTERS OF AMERICA
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:EVP, COO
Authorized Official - Prefix:MS
Authorized Official - First Name:JONI
Authorized Official - Middle Name:G
Authorized Official - Last Name:HYRICK
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:716-691-2309
Mailing Address - Street 1:401 CREEKSIDE DR
Mailing Address - Street 2:
Mailing Address - City:AMHERST
Mailing Address - State:NY
Mailing Address - Zip Code:14228-2040
Mailing Address - Country:US
Mailing Address - Phone:716-691-2311
Mailing Address - Fax:
Practice Address - Street 1:325 S TELLER ST STE 200
Practice Address - Street 2:
Practice Address - City:LAKEWOOD
Practice Address - State:CO
Practice Address - Zip Code:80226-7389
Practice Address - Country:US
Practice Address - Phone:303-934-7000
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:AIRSEP CORPORATION
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2009-06-11
Last Update Date:2009-06-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes367500000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse Anesthetist, Certified RegisteredGroup - Single Specialty