Organization
J K AMBULANCE
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MR. PERRY SHOVE (PRESIDENT)
(208) 276-3789
Entity
Organization
Contact information
Practice address
NO STREET ADDRESS N 6TH ST, KENDRICK, ID 83537
(208) 289-3381
(208) 289-5050
Mailing address
PO BOX 182, KENDRICK, ID 83537-0182
(208) 289-3381
(208) 289-5050
Taxonomy
Speciality
Code
Description
License number
State
341600000X
Ambulance
Primary
7216
ID
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
002514200
—
ID
Enumeration date
10/06/2006
Last updated
06/28/2012
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