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General NPI Number Information
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NPI Number | 1508292871
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Entity Type | Organization
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Legal Business Name | PALOUSE AREA CARE & TRANSPORT
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Dates
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Enumeration Date | 09/18/2013
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Last Update Date | 09/18/2013
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Provider Practice Location Address
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Address Line | 111 N WASHINGTON ST SUITE 3
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City | MOSCOW
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State | ID
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Zip | 83843-2884
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Country | US
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Telephone | 855-722-8367
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Fax |
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Provider Business Mailing Address
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Address Line | 111 N WASHINGTON ST SUITE 3
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City | MOSCOW
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State | ID
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Zip | 83843-2884
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Country | US
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Telephone |
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Fax |
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Authorized Official
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Title or Position | CEO
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Name | TROY ZAKARIASEN
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Credential |
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Telephone | 855-722-8367
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 3416L0300X
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Taxonomy Name | Land Ambulance
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License Number |
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License Number State |
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