Organization
POCATELLO LIMOUSINE LLP
Active
Organization subpart
No
Provider details
NPI number
Authorized official
CHAD A DAVIES (OWNER)
(208) 589-3937
Entity
Organization
Contact information
Practice address
717 W ELDREDGE RD, POCATELLO, ID 83201-5620
(208) 480-1250
Mailing address
717 W ELDREDGE RD, POCATELLO, ID 83201-5620
(208) 480-1250
Taxonomy
Speciality
Code
Description
License number
State
343800000X
Secured Medical Transport (VAN)
—
ID
343900000X
Non-emergency Medical Transport (VAN)
—
ID
347B00000X
Bus
—
ID
347C00000X
Private Vehicle
Primary
—
ID
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1922463751
—
CA
Enumeration date
11/02/2017
Last updated
11/02/2017
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