Healthcare Provider Details

I. General information

NPI: 1538090766
Provider Name (Legal Business Name): EDWARD R SCHAUSTER PARAMEDIC, FP-C
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 05/27/2026
Last Update Date: 05/27/2026
Certification Date: 05/27/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

PO BOX 474
DRIGGS ID
83422-0474
US

IV. Provider business mailing address

PO BOX 202
DRIGGS ID
83422-0202
US

V. Phone/Fax

Practice location:
  • Phone: 208-715-5201
  • Fax: 208-936-7014
Mailing address:
  • Phone: 208-351-1931
  • Fax: 208-936-7014

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code146L00000X
TaxonomyParamedic
License Number24704
License Number StateID

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: