Organization
EAGLES WINGS TRANSPORTATION
Active
Organization subpart
No
Provider details
NPI number
Authorized official
KIMBERLY R COATES (OWNER OPERATOR)
(503) 507-4185
Entity
Organization
Contact information
Practice address
199 VALLEY CT, CHALLIS, ID 83226
(503) 507-4185
Mailing address
PO BOX 209, CHALLIS, ID 83226-0209
Taxonomy
Speciality
Code
Description
License number
State
347C00000X
Private Vehicle
Primary
NS101615A
ID
Other
Enumeration date
03/20/2017
Last updated
03/20/2017
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