Provider Demographics
NPI:1699844316
Name:TREASURE VALLEY PARAMEDICS
Entity Type:Organization
Organization Name:TREASURE VALLEY PARAMEDICS
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CHAIRMAN OF BOARD OF DIRECTORS
Authorized Official - Prefix:
Authorized Official - First Name:ALAN
Authorized Official - Middle Name:S
Authorized Official - Last Name:PATTERSON
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:541-823-8000
Mailing Address - Street 1:1147 SW 4TH AVENUE
Mailing Address - Street 2:
Mailing Address - City:ONTARIO
Mailing Address - State:OR
Mailing Address - Zip Code:97914
Mailing Address - Country:US
Mailing Address - Phone:541-823-8000
Mailing Address - Fax:541-832-8002
Practice Address - Street 1:1147 SW 4TH AVENUE
Practice Address - Street 2:
Practice Address - City:ONTARIO
Practice Address - State:OR
Practice Address - Zip Code:97914
Practice Address - Country:US
Practice Address - Phone:541-881-9930
Practice Address - Fax:541-823-8003
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-11-07
Last Update Date:2015-12-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OR23063416L0300X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes3416L0300XTransportation ServicesAmbulanceLand Transport
Provider Identifiers
StateIdentifier IDID TypeIssuer
OR295825Medicaid
ORR104782OtherPTAN
OR295825Medicaid