Provider Demographics
NPI:1518685049
Name:GRAND VIEW AMBULANCE-RIMROCK SEARCH AND RESCUE, INC.
Entity Type:Organization
Organization Name:GRAND VIEW AMBULANCE-RIMROCK SEARCH AND RESCUE, INC.
Other - Org Name:GRAND VIEW AMBULANCE
Other - Org Type:Doing Business As
Authorized Official - Title/Position:SECRETARY/TREASURER
Authorized Official - Prefix:
Authorized Official - First Name:PAMELA
Authorized Official - Middle Name:ANN
Authorized Official - Last Name:DUGGER
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:208-598-3496
Mailing Address - Street 1:PO BOX 191
Mailing Address - Street 2:
Mailing Address - City:GRAND VIEW
Mailing Address - State:ID
Mailing Address - Zip Code:83624-0191
Mailing Address - Country:US
Mailing Address - Phone:208-598-3496
Mailing Address - Fax:
Practice Address - Street 1:721 S ROOSEVELT STREET
Practice Address - Street 2:
Practice Address - City:GRAND VIEW
Practice Address - State:ID
Practice Address - Zip Code:83624-5015
Practice Address - Country:US
Practice Address - Phone:208-598-3496
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2022-08-19
Last Update Date:2022-10-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes3416L0300XTransportation ServicesAmbulanceLand Transport
Provider Identifiers
StateIdentifier IDID TypeIssuer
ID7305OtherSTATE OF IDAHO EMERGENCY MEDICAL SERVICES