WHITE TAIL TRANSPORTATION, INC. (NPI# 1649621525) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1649621525 |
| Entity Type | Organization |
| Organization Name | WHITE TAIL TRANSPORTATION, INC. |
| Other Organization Name | WHITE TAIL TRANSPORTATION |
| Practice Address |
5486 Highway 2 Ste 102 Priest River ID 83856-6072 |
| Mailing Address |
Po Box 2124 Priest River ID 83856-2124 |
| Practice Telephone | 2084480848 |
| Practice Fax Number | 2084480846 |
| Mailing Telephone | 2084480848 |
| Mailing Fax Number | 2084480846 |
| Enumeration Date | 2016-06-22 |
| Last Update Date | 2016-06-22 |
| Authorized Official Name | DARREN J TALLEY (OWNER) |
| Authorized Official Telephone | 5096824424 |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 343900000X | Non-emergency Medical Transport (VAN) | Transportation Services |
| Other Name | Type Code |
|---|---|
| White Tail Transportation | Doing Business As Name - Organization |
| Entity Type | Entity Name | Entity Address |
|---|---|---|
| Washington State Corporations | WHITE TAIL TRANSPORTATION, INC. | 5486 Hwy 2 Suite 102, Priest River, ID 83856 |
| System for Award Management (SAM) Entities | WHITE TAIL TRANSPORTATION, INC. | 5486 Hwy 2 Ste 102, Priest River, ID 83856-6072 |
| Street Address |
5486 HIGHWAY 2 STE 102 |
| City | PRIEST RIVER |
| State | ID |
| Zip Code | 83856-6072 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1457950750 | Jill Willett | Pharmacist | 5453 Us Hwy 2, Priest River, ID 83856 | 2020-10-19 |
| 1104316785 | Pend Oreille Vision Care | Clinic/Center | 6132 Highway 2, Priest River, ID 83856 | 2018-05-18 |
| 1700209061 | Sequel Alliance Family Services, LLC | Counselor | 5486 Highway 2 Ste102, Priest River, ID 83856 | 2014-01-22 |
| 1801035878 | Albeni-selkirk Counseling Services | Community/Behavioral Health | 310 Albeni Rd., Ste. B, Priest River, ID 83856 | 2009-02-13 |
| 1679764898 | Healing Partners Equestrian Program | Community/Behavioral Health | 1605 Hoodoo Mt. Road, Priest River, ID 83856 | 2007-08-05 |
| 1710191796 | Delores Dianne Miller | Massage Therapist | 208 9th, Priest River, ID 83856 | 2007-05-09 |
| 1639382419 | Ken Miller | Massage Therapist | 208 Ninth St, Priest River, ID 83856 | 2007-05-08 |
| 1861619520 | Alliance Family Services North, Inc. | Community/Behavioral Health | 5486 Highway 2, Ste. 102, Priest River, ID 83856 | 2007-04-20 |
| 1376681460 | Lynne Anne Certain | Counselor | 301 Albeni Rd., Suite C, Priest River, ID 83856 | 2007-02-02 |
| 1093702227 | Richard Allan De Blaquiere | Pharmacist | 5453 Highway 2, Priest River, ID 83856 | 2005-10-03 |
| Find all providers in zip 83856 | ||||
| Taxonomy Code | 343900000X |
| Grouping | Transportation Services |
| Classification | Non-emergency Medical Transport (VAN) |
| A land vehicle with a capacity to meet special height, clearance, access, and seating, for the conveyance of persons in non-emergency situations. The vehicle may or may not be required to meet local county or state regulations. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1639714025 | Jonathan Amissa | Non-emergency Medical Transport (VAN) | 1573 S Riverstone Ln Apt 303, Boise, ID 83706-6542 | 2019-11-09 |
| 1336613306 | Suzanne R Baker | Non-emergency Medical Transport (VAN) | 1190 Twin Butte Rd, Menan, ID 83434-5117 | 2019-01-14 |
| 1598263394 | Frances Hammons | Non-emergency Medical Transport (VAN) | 60 East 2nd Ave, Glenns Ferry, ID 83623 | 2018-01-26 |
| 1740799832 | Freedom Shuttle Service Inc | Non-emergency Medical Transport (VAN) | 635 E State Ave, Meridian, ID 83642-2354 | 2017-09-21 |
| 1477072270 | Matthew Lee Love | Non-emergency Medical Transport (VAN) | 6933 W. Stratton St, Boise, ID 83704 | 2017-09-12 |
| 1982144192 | Fran's Affordable Rides | Non-emergency Medical Transport (VAN) | 3190 Nw Lancaster Ln, #33, Mountain Home, ID 83647-5778 | 2017-03-07 |
| 1942740857 | Idaho Transport LLC | Non-emergency Medical Transport (VAN) | 9616 W Bienapfl Dr, Boise, ID 83709-4709 | 2017-02-27 |
| 1750827770 | Road Runner Shuttle, LLC | Non-emergency Medical Transport (VAN) | 310 Moonlite Dr, Apt 25, Idaho Falls, ID 83402-2359 | 2017-01-14 |
| 1417493560 | Joann's Shuttle | Non-emergency Medical Transport (VAN) | 6555 N Old Highway 191, Malad City, ID 83252-5072 | 2017-01-13 |
| 1376085795 | Integrity Plus Transportation | Non-emergency Medical Transport (VAN) | 6616 S Cheshire Ave, Boise, ID 83709-6582 | 2016-11-16 |
| Find all providers with the same taxonomy | ||||
| City | PRIEST RIVER |
| Zip Code | 83856 |
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| 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.