Provider Demographics
NPI:1689827974
Name:LADDGAS, LLC
Entity type:Organization
Organization Name:LADDGAS, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:MR
Authorized Official - First Name:LADD
Authorized Official - Middle Name:
Authorized Official - Last Name:SHANER
Authorized Official - Suffix:
Authorized Official - Credentials:CRNA
Authorized Official - Phone:440-338-6955
Mailing Address - Street 1:8766 GALLOWAY TRL
Mailing Address - Street 2:
Mailing Address - City:NOVELTY
Mailing Address - State:OH
Mailing Address - Zip Code:44072-9653
Mailing Address - Country:US
Mailing Address - Phone:440-338-6955
Mailing Address - Fax:
Practice Address - Street 1:225 ELYRIA ST
Practice Address - Street 2:
Practice Address - City:LODI
Practice Address - State:OH
Practice Address - Zip Code:44254-1031
Practice Address - Country:US
Practice Address - Phone:330-948-1222
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2008-10-30
Last Update Date:2008-10-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OH042823367500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes367500000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse Anesthetist, Certified RegisteredGroup - Single Specialty