Provider Demographics
NPI:1104974948
Name:ROYAL ANESTHESIA SERVICES, PC
Entity type:Organization
Organization Name:ROYAL ANESTHESIA SERVICES, PC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:ANDRES
Authorized Official - Middle Name:
Authorized Official - Last Name:PICHARDO
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:812-934-5974
Mailing Address - Street 1:PO BOX 249
Mailing Address - Street 2:
Mailing Address - City:BATESVILLE
Mailing Address - State:IN
Mailing Address - Zip Code:47006-0249
Mailing Address - Country:US
Mailing Address - Phone:812-934-5974
Mailing Address - Fax:812-934-5974
Practice Address - Street 1:720 N LINCOLN ST
Practice Address - Street 2:
Practice Address - City:GREENSBURG
Practice Address - State:IN
Practice Address - Zip Code:47240-1327
Practice Address - Country:US
Practice Address - Phone:812-934-5974
Practice Address - Fax:812-934-5974
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-01-08
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IN01032603207L00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207L00000XAllopathic & Osteopathic PhysiciansAnesthesiologyGroup - Single Specialty