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General NPI Number Information
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NPI Number | 1093368961
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Entity Type | Organization
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Legal Business Name | DISPATCHHEALTH-IDAHO PC
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Dates
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Enumeration Date | 07/19/2019
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Last Update Date | 07/07/2025
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Provider Practice Location Address
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Address Line | 1105 2ND ST S STE 100
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City | NAMPA
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State | ID
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Zip | 83651-3911
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Country | US
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Telephone | 208-268-8024
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Fax |
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Provider Business Mailing Address
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Address Line | 3455 RINGSBY CT STE 102
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City | DENVER
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State | CO
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Zip | 80216-4923
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Country | US
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Telephone | 303-500-1518
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Fax |
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Authorized Official
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Title or Position | CHIEF LEGAL OFFICER
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Name | WILLIAM KRAMER
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Credential |
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Telephone | 215-813-5940
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 207P00000X
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Taxonomy Name | Emergency Medicine Physician
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License Number |
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License Number State |
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