Organization
MIDVALE FIRE PROTECTION DISTRICT
Active
Organization
MIDVALE FIRE PROTECTION DISTRICT
Active
Other names
Midvale Ambulance
Organization subpart
No
Provider details
NPI number
Authorized official
BRIAN GRAHAM (EMS SUPERVISOR)
(208) 550-1605
Entity
Organization
Contact information
Practice address
10 S RIVER STREET, MIDVALE, ID 83645
(208) 550-1605
Mailing address
PO BOX 131, MIDVALE, ID 83645-0131
(208) 550-1605
Taxonomy
Speciality
Code
Description
License number
State
3416L0300X
Land Ambulance
Primary
5317
ID
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
000010014799
BLUE SHIELD
ID
05
—
0024624
—
ID
Enumeration date
04/24/2008
Last updated
04/24/2008
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