Organization
DEARY AMBULANCE
Active
Organization subpart
No
Provider details
NPI number
Authorized official
BRIAN ROBERTSON FIRST RESPONDER (TREASURER)
(208) 877-1515
Entity
Organization
Contact information
Practice address
403 MAIN ST, DEARY, ID 83823-9601
(208) 877-1515
Mailing address
403 MAIN ST, DEARY, ID 83823-9601
(208) 877-1515
Taxonomy
Speciality
Code
Description
License number
State
3416L0300X
Land Ambulance
Primary
7212
ID
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
8053327
—
ID
Enumeration date
06/08/2005
Last updated
08/22/2020
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