Healthcare Provider Details

I. General information

NPI: 1285557439
Provider Name (Legal Business Name): GEM STATE CARE MOBILITY LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 08/04/2026
Last Update Date: 08/10/2026
Certification Date: 08/10/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

6751 S SOLAR AVE
BOISE ID
83709-6383
US

IV. Provider business mailing address

6751 S SOLAR AVE
BOISE ID
83709-6383
US

V. Phone/Fax

Practice location:
  • Phone: 208-972-6105
  • Fax:
Mailing address:
  • Phone: 208-972-6105
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code347E00000X
TaxonomyTransportation Broker
License Number
License Number State

VIII. Authorized Official

Name: MUHAMUD MOHAMED ABDILE
Title or Position: CO OWNER
Credential:
Phone: 208-972-6105