# COEUR D' ALENE ANESTHESIA

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- **Entity:** Organization
- **Status:** Active
- **Organization subpart:** No

## Provider details

- **NPI number:** 1093796468
- **Authorized official:** RONALD ROCK CRNA (PRESIDENT)
- **Authorized official phone:** (208) 262-2314

## Contact information

- **Practice address:** 1593 E POLSTON AVE, POST FALLS, ID 83854-5326
- **Practice address phone:** (208) 262-2314
- **Practice address fax:** (208) 262-2394
- **Mailing address:** 1593 E POLSTON AVE, POST FALLS, ID 83854-5326
- **Mailing address phone:** (208) 262-2314
- **Mailing address fax:** (208) 262-2394

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 174400000X | Specialist | — | NULL | Yes |
| 174400000X | Specialist | — | — | Yes |

## Other

- **Enumeration date:** 11/10/2005
- **Last updated:** 08/22/2020