| NPI | 1508003104 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | RANDALL SCOTT FOWLER President 208-239-1111 |
| Organization Subpart ? | No |
| Primary Taxonomy | 207PE0004X Emergency Medicine, Emergency Medical Services (Licence: ID M4363) |
| Enumeration Date | 2009-01-19 |
| Last Update Date | 2011-05-11 |