MEDICARE: GRAND VIEW AMBULANCE-RIMROCK SEARCH AND RESCUE, INC.

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	3416L0300X	Land Ambulance

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	7305	OTHER	ID	STATE OF IDAHO EMERGENCY MEDICAL SERVICES

General Provider Information

NPI Number	:	1518685049
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	GRAND VIEW AMBULANCE-RIMROCK SEARCH AND RESCUE, INC.

Provider Business Mailing Address
First Line	:	PO BOX 191
Second Line	:
City	:	GRAND VIEW
State	:	ID
Zip	:	83624-0191
Country	:	US
Telephone Number	:	208-598-3496
Fax Number	:

Provider Business Practice Location Address
First Line	:	721 S ROOSEVELT STREET
Second Line	:
City	:	GRAND VIEW
State	:	ID
Zip	:	83624-5015
Country	:	US
Telephone Number	:	208-598-3496
Fax Number	:

Authorized Official
Title or Position	:	TREASURER
Name	:	SHERWIN SUNDBERG
Credential	:
Telephone Number	:	208-599-4651

Provider Enumeration Date	:	08/19/2022
Last Update Date	:	05/17/2025

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