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General NPI Number Information
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NPI Number | 1124193271
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Entity Type | Organization
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Legal Business Name | WESTERN MEDICAL SERVICES OF TREASURE VALLEY, INC.
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Dates
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Enumeration Date | 11/22/2006
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Last Update Date | 08/22/2020
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Provider Practice Location Address
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Address Line | 2950 E. MAGIC VIEW DR. # 192
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City | MERIDIAN
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State | ID
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Zip | 83642
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Country | US
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Telephone | 208-401-0112
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Fax | 208-401-0118
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Provider Business Mailing Address
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Address Line | 2950 E. MAGIC VIEW DR. # 192
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City | MERIDIAN
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State | ID
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Zip | 83642
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Country | US
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Telephone | 208-401-0112
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Fax | 208-401-0118
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Authorized Official
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Title or Position | PRESIDENT
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Name | MICHAEL KEITH DEMPSEY
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Credential |
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Telephone | 208-401-0112
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 251E00000X
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Taxonomy Name | Home Health Agency
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License Number | HH127
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License Number State | ID
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