Provider Demographics
NPI:1306838370
Name:ANESTHESIA SERVICES, INC.
Entity Type:Organization
Organization Name:ANESTHESIA SERVICES, INC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:KAREN
Authorized Official - Middle Name:
Authorized Official - Last Name:YOUNG
Authorized Official - Suffix:
Authorized Official - Credentials:CRNA
Authorized Official - Phone:808-895-8585
Mailing Address - Street 1:PO BOX 1840
Mailing Address - Street 2:
Mailing Address - City:KAILUA KONA
Mailing Address - State:HI
Mailing Address - Zip Code:96745-1840
Mailing Address - Country:US
Mailing Address - Phone:808-325-6760
Mailing Address - Fax:
Practice Address - Street 1:4366 KUKUI GROVE ST
Practice Address - Street 2:
Practice Address - City:LIHUE
Practice Address - State:HI
Practice Address - Zip Code:96766-2006
Practice Address - Country:US
Practice Address - Phone:808-245-1100
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2005-08-16
Last Update Date:2007-11-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
HIAPRN250367500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes367500000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse Anesthetist, Certified RegisteredGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
HI53018002Medicaid
HIA22088-7OtherHMSA
HIA22088-7OtherHMSA