Healthcare Provider Details

I. General information

NPI: 1548183312
Provider Name (Legal Business Name): PRISTINE HEALTH TRANSPORT LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 07/30/2026
Last Update Date: 07/30/2026
Certification Date: 07/30/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2182 BITTERROOT DR
TWIN FALLS ID
83301-3576
US

IV. Provider business mailing address

2182 BITTERROOT DR
TWIN FALLS ID
83301-3576
US

V. Phone/Fax

Practice location:
  • Phone: 208-613-0927
  • Fax:
Mailing address:
  • Phone: 208-613-0927
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code342000000X
TaxonomyTransportation Network Company
License Number
License Number State

VIII. Authorized Official

Name: GALEN HAMANN
Title or Position: OWNER/OPERATOR
Credential:
Phone: 208-613-0927