Healthcare Provider Details

I. General information

NPI: 1346631058
Provider Name (Legal Business Name): MEADOWS VALLEY RURAL FIRE DISTRICT
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 02/17/2015
Last Update Date: 08/23/2025
Certification Date: 08/23/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

200 HWY 95
NEW MEADOWS ID
83654
US

IV. Provider business mailing address

PO BOX 523
NEW MEADOWS ID
83654
US

V. Phone/Fax

Practice location:
  • Phone: 208-347-3190
  • Fax: 208-347-3190
Mailing address:
  • Phone: 208-347-3190
  • Fax: 208-347-3190

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code3416L0300X
TaxonomyLand Ambulance
License Number5313
License Number StateID

VIII. Authorized Official

Name: CODY DEAN KILLMAR
Title or Position: ADMIN ASSISTANT
Credential:
Phone: 208-983-9263