Healthcare Provider Details

I. General information

NPI: 1245985035
Provider Name (Legal Business Name): QUALITY CARE TRANSPORT LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 02/20/2022
Last Update Date: 03/25/2026
Certification Date: 03/25/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

212 EMERALD DR
KELLOGG ID
83837-2231
US

IV. Provider business mailing address

212 EMERALD DR
KELLOGG ID
83837-2231
US

V. Phone/Fax

Practice location:
  • Phone: 208-512-1027
  • Fax:
Mailing address:
  • Phone: 208-512-1027
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code347E00000X
TaxonomyTransportation Broker
License Number
License Number State
# 2
Primary TaxonomyY
Taxonomy Code342000000X
TaxonomyTransportation Network Company
License Number
License Number State

VIII. Authorized Official

Name: JESSICA DEBRA CROSTON
Title or Position: OWNER
Credential:
Phone: 208-512-1027