Healthcare Provider Details

I. General information

NPI: 1255144002
Provider Name (Legal Business Name): IDOL TRANSPORTATION, LLC.
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 01/27/2025
Last Update Date: 01/27/2025
Certification Date: 01/27/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2451 W SNYDER ST
MERIDIAN ID
83642-7621
US

IV. Provider business mailing address

2451 W SNYDER ST
MERIDIAN ID
83642-7621
US

V. Phone/Fax

Practice location:
  • Phone: 208-600-2721
  • Fax:
Mailing address:
  • Phone: 208-600-2721
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code343900000X
TaxonomyNon-emergency Medical Transport (VAN)
License Number
License Number State

VIII. Authorized Official

Name: DANIEL RAMIREZ
Title or Position: OWNER/OPERATOR
Credential:
Phone: 208-600-2721