Provider Demographics
NPI:1912189481
Name:EMERGENCY RESPONDERS HEALTH CENTER, LLC
Entity Type:Organization
Organization Name:EMERGENCY RESPONDERS HEALTH CENTER, LLC
Other - Org Name:DOCTORS FOR IDAHO FIRE SERVICES, LLC
Other - Org Type:Former Legal Business Name
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:ROBERT
Authorized Official - Middle Name:JOSEPH
Authorized Official - Last Name:HILVERS
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:208-381-0697
Mailing Address - Street 1:PO BOX 44828
Mailing Address - Street 2:
Mailing Address - City:BOISE
Mailing Address - State:ID
Mailing Address - Zip Code:83711-0828
Mailing Address - Country:US
Mailing Address - Phone:208-394-9022
Mailing Address - Fax:208-947-3465
Practice Address - Street 1:9976 W EMERALD ST
Practice Address - Street 2:
Practice Address - City:BOISE
Practice Address - State:ID
Practice Address - Zip Code:83704-9769
Practice Address - Country:US
Practice Address - Phone:208-229-3742
Practice Address - Fax:208-229-8450
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-11-27
Last Update Date:2014-08-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IDM-7543261QP2300X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QP2300XAmbulatory Health Care FacilitiesClinic/CenterPrimary Care