Provider Demographics
NPI:1548201494
Name:SCHILSKY CHIROPRACTIC CENTER PA
Entity Type:Organization
Organization Name:SCHILSKY CHIROPRACTIC CENTER PA
Other - Org Name:SCHILSKY CHIROPRACTIC CENTER
Other - Org Type:Doing Business As
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:RANDY
Authorized Official - Middle Name:M
Authorized Official - Last Name:SCHILSKY
Authorized Official - Suffix:
Authorized Official - Credentials:DC
Authorized Official - Phone:910-347-4033
Mailing Address - Street 1:312 DOLPHIN DR
Mailing Address - Street 2:
Mailing Address - City:JACKSONVILLE
Mailing Address - State:NC
Mailing Address - Zip Code:28546-5266
Mailing Address - Country:US
Mailing Address - Phone:910-347-4033
Mailing Address - Fax:910-347-0854
Practice Address - Street 1:312 DOLPHIN DR
Practice Address - Street 2:
Practice Address - City:JACKSONVILLE
Practice Address - State:NC
Practice Address - Zip Code:28546-5266
Practice Address - Country:US
Practice Address - Phone:910-347-4033
Practice Address - Fax:910-347-0854
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-06-10
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NC2013111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes111N00000XChiropractic ProvidersChiropractorGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
NC89085J3Medicaid
NC89085KJMedicaid
NC890838VMedicaid
NC890824GMedicaid
NCU43744Medicare UPIN
NC2455466Medicare ID - Type Unspecified
NCU93713Medicare UPIN
NC890838VMedicaid
NC2455723Medicare ID - Type Unspecified
NC2453239Medicare ID - Type Unspecified
NC89085J3Medicaid
NC890824GMedicaid