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General NPI Number Information
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NPI Number | 1245434380
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Entity Type | Organization
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Legal Business Name | THE VOLUNTEER FIRE DEPARTMENT OF MOSCOW, IDAHO INC.
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Dates
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Enumeration Date | 06/13/2007
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Last Update Date | 05/06/2013
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Provider Practice Location Address
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Address Line | 603 S MAIN ST
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City | MOSCOW
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State | ID
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Zip | 83843
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Country | US
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Telephone | 208-883-7081
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Fax | 208-883-7083
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Provider Business Mailing Address
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Address Line | 603 S MAIN ST
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City | MOSCOW
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State | ID
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Zip | 83843-3039
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Country | US
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Telephone | 208-882-2831
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Fax | 208-882-5746
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Authorized Official
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Title or Position | EMS DIVISION CHIEF
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Name | RICHARD DAVID REYNOLDS
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Credential |
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Telephone | 208-883-7081
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 146M00000X
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Taxonomy Name | Intermediate Emergency Medical Technician
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License Number | 7203
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License Number State | ID
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Taxonomy #2
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Taxonomy Code | 146N00000X
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Taxonomy Name | Basic Emergency Medical Technician
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License Number | 7203
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License Number State | ID
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Taxonomy #3
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Taxonomy Code | 146L00000X
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Taxonomy Name | Paramedic
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License Number | 7203
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License Number State | ID
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