Organization
JAE'S TRANSPORTAION LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MR. JUSTIN M KUDLACZ (OWNER)
(208) 577-1337
Entity
Organization
Contact information
Practice address
14310 TARA ST, CALDWELL, ID 83607-1431
(208) 577-1337
Mailing address
14310 TARA ST, CALDWELL, ID 83607-1431
(208) 577-1337
Taxonomy
Speciality
Code
Description
License number
State
343900000X
Non-emergency Medical Transport (VAN)
Primary
BB237706C
ID
Other
Enumeration date
06/17/2016
Last updated
06/17/2016
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