Organization
IDAHO TRANSPORT LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MR. ANDREW ODOM BS (OWNER)
(208) 854-9076
Entity
Organization
Contact information
Practice address
9616 W BIENAPFL DR, BOISE, ID 83709-4709
(208) 854-9076
Mailing address
9616 W BIENAPFL DR, BOISE, ID 83709-4709
(208) 854-9076
Taxonomy
Speciality
Code
Description
License number
State
343900000X
Non-emergency Medical Transport (VAN)
Primary
—
—
Other
Enumeration date
02/27/2017
Last updated
02/27/2017
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