Organization
MAGIC VALLEY PARAMEDICS , LTD.
Active
Organization subpart
No
Provider details
NPI number
Authorized official
JIM ANGLE (CEO)
(208) 737-2101
Entity
Organization
Contact information
Practice address
285 MARTIN ST, TWIN FALLS, ID 83301-4532
(208) 737-2298
Mailing address
PO BOX 367, TWIN FALLS, ID 83303-0367
(208) 814-7459
(208) 814-7491
Taxonomy
Speciality
Code
Description
License number
State
3416L0300X
Land Ambulance
Primary
—
ID
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
000010149121
BLUE SHIELD PROV NUMBER
ID
05
—
807075100
—
ID
01
—
E1144
BLUE CROSS PROV NUMBER
ID
01
—
P00719362
MEDICARE RR
—
Enumeration date
03/07/2007
Last updated
09/24/2014
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