Provider Demographics
NPI:1417522848
Name:TRILLIUM ANESTHESIA SERVICES, PLLC
Entity Type:Organization
Organization Name:TRILLIUM ANESTHESIA SERVICES, PLLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:ADMINISTRATOR
Authorized Official - Prefix:
Authorized Official - First Name:JENNIFER
Authorized Official - Middle Name:
Authorized Official - Last Name:KELLAY
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:586-228-5300
Mailing Address - Street 1:37399 GARFIELD RD STE 104
Mailing Address - Street 2:
Mailing Address - City:CLINTON TOWNSHIP
Mailing Address - State:MI
Mailing Address - Zip Code:48036-3672
Mailing Address - Country:US
Mailing Address - Phone:586-228-5300
Mailing Address - Fax:586-279-5284
Practice Address - Street 1:37399 GARFIELD RD STE 104
Practice Address - Street 2:
Practice Address - City:CLINTON TOWNSHIP
Practice Address - State:MI
Practice Address - Zip Code:48036-3672
Practice Address - Country:US
Practice Address - Phone:586-228-5300
Practice Address - Fax:586-279-5284
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2021-05-27
Last Update Date:2022-01-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207L00000XAllopathic & Osteopathic PhysiciansAnesthesiologyGroup - Single Specialty