Provider Demographics
NPI:1386815330
Name:SCHILLAR ANESTHESIA SERVICES INC
Entity Type:Organization
Organization Name:SCHILLAR ANESTHESIA SERVICES INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:SELF OWNER
Authorized Official - Prefix:
Authorized Official - First Name:PAMELLA
Authorized Official - Middle Name:
Authorized Official - Last Name:SCHILLAR
Authorized Official - Suffix:
Authorized Official - Credentials:CRNA
Authorized Official - Phone:208-946-0829
Mailing Address - Street 1:PO BOX 591
Mailing Address - Street 2:
Mailing Address - City:SAGLE
Mailing Address - State:ID
Mailing Address - Zip Code:83860
Mailing Address - Country:US
Mailing Address - Phone:208-265-3534
Mailing Address - Fax:208-265-3534
Practice Address - Street 1:520 N 3RD AVE
Practice Address - Street 2:
Practice Address - City:SANDPOINT
Practice Address - State:ID
Practice Address - Zip Code:83864
Practice Address - Country:US
Practice Address - Phone:208-946-0829
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2008-03-18
Last Update Date:2008-03-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IDRNA633367500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes367500000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse Anesthetist, Certified RegisteredGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
ID1369087Medicare PIN