| Organization Name: | LOST RIVER EMT |
| NPI Number: | 1588910913 |
| Entity Type Code: | Organizational (2) |
| Authorized Official Name: | ROBERT MOZES (PRESIDENT) |
| Mailing Address: | 201 N. Idaho St. Arco |
| State: | ID US |
| Postal Code: | 832130503 |
| Phone Number: | 2085273046 |
| Fax Number: | |
| NPI Enumeration Date: | 08/03/2012 |
| NPI Last Update Date: | 08/03/2012 |
| Replacement NPI: | 0 |
| NPI Deactivation Date: | |
| NPI Reactivation Date: |
Taxonomy Information: | |
| Healthcare Provider Taxonomy: | 3416L0300X |
| License Number: | 7707 |
| Healthcare Provider Taxonomy: (Secondary) | Y |
| State: | ID |
| Taxonomy Type: | Transportation Services |
| Taxonomy Classification: | Ambulance |
| Taxonomy Specialization: | Land Transport |
| Taxonomy Definition: | |