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General NPI Number Information
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NPI Number | 1245680198
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Entity Type | Organization
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Legal Business Name | GREEN ZONE TRANSPORTATION
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Dates
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Enumeration Date | 06/21/2016
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Last Update Date | 06/21/2016
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Provider Practice Location Address
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Address Line | 119 S VALLEY DR SUITE A123
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City | NAMPA
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State | ID
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Zip | 83686-2974
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Country | US
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Telephone | 208-800-8437
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Fax |
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Provider Business Mailing Address
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Address Line | 119 S VALLEY DR SUITE A123
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City | NAMPA
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State | ID
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Zip | 83686-2974
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Country | US
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Telephone | 208-800-8437
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Fax |
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Authorized Official
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Title or Position | OWNER
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Name | MR. GEORGE TODOR
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Credential |
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Telephone | 208-800-8437
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 343900000X
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Taxonomy Name | Non-emergency Medical Transport (VAN)
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License Number | D186444
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License Number State | ID
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