Prairie Transportation 1 LLC

NPI #1841640406 in Lewiston, Idaho

Provider Information

NPI Number
1841640406
Entity Type
Organization
Organization Name
Prairie Transportation 1 LLC
Primary Specialty
Non-emergency Medical Transport (VAN)
Enumeration Date
Jun 15, 2016
Last Updated
Jun 15, 2016

Practice Location

Address
2706 GRELLE AVE
State
Idaho
ZIP Code
83501-9742
Phone
(208) 798-1508

Authorized Official

Name
SCOTT BAGLEY
Title
OWNER
Phone
(208) 717-7179

Specialties & Taxonomy Codes

Specialty
Non-emergency Medical Transport (VAN)

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