VICTORY MEDICAL TRANSPORTATION, INC. (NPI# 1770058265) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1770058265 |
| Entity Type | Organization |
| Organization Name | VICTORY MEDICAL TRANSPORTATION, INC. |
| Other Organization Name | VICTORY EMS |
| Practice Address |
655 N Five Mile Rd Boise ID 83713-8025 |
| Mailing Address |
1606 W Whispering Wind Dr # 101 Phoenix AZ 85085-1322 |
| Practice Telephone | 2084011400 |
| Practice Fax Number | 2084011401 |
| Mailing Telephone | 2084011400 |
| Mailing Fax Number | 2084011401 |
| Enumeration Date | 2018-10-10 |
| Last Update Date | 2018-12-19 |
| Authorized Official Name | SOON BURNAM (TREASURER) |
| Authorized Official Telephone | 9495401249 |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 3416L0300X |
Ambulance Specialization: Land Transport |
Transportation Services |
| Other Name | Type Code |
|---|---|
| Victory EMS | Doing Business As Name - Organization |
| Street Address |
655 N FIVE MILE RD |
| City | BOISE |
| State | ID |
| Zip Code | 83713-8025 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1265902332 | Kidscare Home Health of Idaho, LLC | Home Health | 1835 Wildwood Street, Boise, ID 83713 | 2018-11-30 |
| 1417463928 | Kimberly Ann Bohrer | Behavioral Analyst | 12053 W Hickory Dr, Boise, ID 83713 | 2017-12-19 |
| 1407371891 | Emir Hadzic | Optometrist | 13239 W. Fernleaf St., Boise, ID 83713 | 2017-08-07 |
| 1518336650 | Alliance Physical Medicine | Nurse Practitioner | 13909 W Wainwright Drive, Boise, ID 83713 | 2015-09-18 |
| 1083038335 | Jan L Rehder | Nurse Practitioner | 13150 W Persimmon Lane, Boise, ID 83713 | 2014-02-06 |
| 1508287061 | Heather N Fox | Physician Assistant | 12273 West Mcmillan Road, Boise, ID 83713 | 2013-12-30 |
| 1659667459 | Jayson Clark | Dentist | 4274 N Eagle Road, Boise, ID 83713 | 2011-06-21 |
| 1043503659 | Steven Anthony Eckhoff | Physician Assistant | 11662 W Arlen St, Boise, ID 83713 | 2011-05-16 |
| 1790923621 | Christie Dudash Flynn | Physician Assistant | 12273 W Mcmillian Road, Boise, ID 83713 | 2009-01-30 |
| 1699930404 | Dennis J. Garpetti, Dds, P.C. | Dentist | 13108 West Persimmon Lane, Boise, ID 83713 | 2008-07-21 |
| Find all providers in zip 83713 | ||||
| Taxonomy Code | 3416L0300X |
| Grouping | Transportation Services |
| Classification | Ambulance |
| Specialization | Land Transport |
| Definition to come... |
| Notes: [1/1/2005: title modified] |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1366647505 | Northwest Paramedic Associates Inc. | Ambulance | 10400 W Overland Rd, #105, Boise, ID 83709-1433 | 2007-06-18 |
| 1740251925 | Ada Boi Inc | Ambulance | 7701 W Mossy Cup St, Boise, ID 83709-2844 | 2006-01-27 |
| 1700889987 | County of Ada | Ambulance | 370 N. Benjamin Lane, Boise, ID 83704 | 2005-05-23 |
| 1093952947 | Injury Care Emergency Medical Services | Ambulance | 4850 N Rosepoint Way, Ste 100, Boise, ID 83713-5262 | 2009-01-14 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1316465453 | County of Elmore | Ambulance | 2259 E. 8th N., Mountain Home, ID 83647-8364 | 2017-09-08 |
| 1790136091 | Teton County Fire Protection Dist | Ambulance | 911 North Hwy 33, Driggs, ID 83422 | 2016-06-28 |
| 1619394020 | Garden Valley Fire Protection | Ambulance | 373 S. Middle Fork Rd., Garden Valley, ID 83622-0000 | 2014-03-24 |
| 1588910913 | Lost River Emt | Ambulance | 201 N. Idaho St., Arco, ID 83213-0503 | 2012-08-03 |
| 1023393709 | City of Troy | Ambulance | 521 Eagle Alley, Troy, ID 83871 | 2011-10-13 |
| 1548567027 | Prichard-murray Volunteer Fire Department Inc. | Ambulance | 21109 Coeur Dalene River Rd, Wallace, ID 83873-5043 | 2011-02-18 |
| 1023332392 | Newport Emergency Services Inc | Ambulance | 203 E 4th St N, Oldtown, ID 83822-9546 | 2010-03-16 |
| 1700051471 | Midvale Fire Protection District | Ambulance | 10 S River Street, Midvale, ID 83645 | 2008-04-24 |
| 1720257272 | Grand View Ambulance-rimrock Searech and Rescue, Inc | Ambulance | 720 Roosevelt Ave, Grand View, ID 83624-5079 | 2008-02-28 |
| 1235323452 | Palisades Bonneville County Rescue | Ambulance | Hwy 31 # 15, Swan Valley, ID 83449 | 2007-08-30 |
| Find all providers with the same taxonomy | ||||
Please comment or provide details below to improve the information on VICTORY MEDICAL TRANSPORTATION, INC..
| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.