Organization
BLUE BIRDS SPECIALTY SERVICES LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MR. ISMAEL MANUEL MEDINA (MEMBER/MANAGER)
(208) 750-8726
Entity
Organization
Contact information
Practice address
1122 W FINCH DR, NAMPA, ID 83651-1732
(208) 577-0876
Mailing address
1122 W FINCH DR, NAMPA, ID 83651-1732
(208) 577-0876
Taxonomy
Speciality
Code
Description
License number
State
343900000X
Non-emergency Medical Transport (VAN)
Primary
—
—
Other
Enumeration date
09/10/2012
Last updated
09/10/2012
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