Provider Demographics
NPI:1982740890
Name:TENSED AMBULANCE SERVICE
Entity Type:Organization
Organization Name:TENSED AMBULANCE SERVICE
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:BUSINESS MANAGER
Authorized Official - Prefix:MRS
Authorized Official - First Name:LEANN
Authorized Official - Middle Name:
Authorized Official - Last Name:DAMAN
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:208-274-3026
Mailing Address - Street 1:PO BOX 6
Mailing Address - Street 2:311 HWY 95
Mailing Address - City:TENSED
Mailing Address - State:ID
Mailing Address - Zip Code:83870-0006
Mailing Address - Country:US
Mailing Address - Phone:208-274-3026
Mailing Address - Fax:208-274-3026
Practice Address - Street 1:311 HWY 95
Practice Address - Street 2:
Practice Address - City:TENSED
Practice Address - State:ID
Practice Address - Zip Code:83870-0006
Practice Address - Country:US
Practice Address - Phone:208-274-3026
Practice Address - Fax:208-274-3026
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-01-29
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
ID51083416L0300X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes3416L0300XTransportation ServicesAmbulanceLand Transport
Provider Identifiers
StateIdentifier IDID TypeIssuer
ID000010014323OtherREGENCE BS IDAHO #
IDE0872OtherBLUE CROSS OF IDAHO #
ID1502994Medicare ID - Type UnspecifiedID #