Organization
AJ TRANSPORT
Active
Organization subpart
No
Provider details
NPI number
Authorized official
JUDY LYNN SHAFER (OWNER/OPERATOR)
(208) 755-1040
Entity
Organization
Contact information
Practice address
510 S. 6TH ST., PINEHURST, ID 83850
(208) 755-1040
Mailing address
PO BOX 58, KINGSTON, ID 83839-0058
(208) 755-1040
Taxonomy
Speciality
Code
Description
License number
State
343900000X
Non-emergency Medical Transport (VAN)
Primary
PW213673B
ID
Other
Enumeration date
09/01/2016
Last updated
09/01/2016
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