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Organization

ANESTHESIA WEST, PA

Active
Organization subpart
No

Provider details

NPI number
Authorized official
CHRIS CHAD FUGATE CRNA (PRESIDENT)
(208) 525-2090
Entity
Organization

Contact information

Practice address
1501 HILAND AVE, BURLEY, ID 83318-2682
(208) 525-2090
(208) 525-2662
Mailing address
PO BOX 3659, IDAHO FALLS, ID 83403-3659
(208) 525-2090
(208) 525-2662

Taxonomy

Speciality
Code
Description
License number
State
367500000X
Certified Registered Nurse Anesthetist
Primary
N-16877
ID

Other

Enumeration date
12/07/2006
Last updated
02/15/2011
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