| Organization Name: | MEADOW VALLEY AMBULANCE SERVICE, INC. |
| NPI Number: | 1689778391 |
| Entity Type Code: | Organizational (2) |
| Authorized Official Name: | JACOB MAC QUALLS (EMS CHIEF) |
| Mailing Address: | 200 Hwy 95 New Meadows |
| State: | ID US |
| Postal Code: | 83654 |
| Phone Number: | 2083473190 |
| Fax Number: | |
| NPI Enumeration Date: | 09/12/2006 |
| NPI Last Update Date: | 01/18/2013 |
| Replacement NPI: | 0 |
| NPI Deactivation Date: | |
| NPI Reactivation Date: |
Taxonomy Information: | |
| Healthcare Provider Taxonomy: | 3416L0300X |
| License Number: | #5313 |
| Healthcare Provider Taxonomy: (Secondary) | Y |
| State: | ID |
| Taxonomy Type: | Transportation Services |
| Taxonomy Classification: | Ambulance |
| Taxonomy Specialization: | Land Transport |
| Taxonomy Definition: | |