| Emergacare | |
|
190 Mustang Drive Driggs ID 83422-0000 | |
| (307) 733-7835 | |
| (307) 201-4999 |
| Full Name | Emergacare |
|---|---|
| Speciality | Family Medicine |
| Location | 190 Mustang Drive, Driggs, Idaho |
| Authorized Official Name and Position | Brent Blue (OWNER) |
| Authorized Official Contact | 3077337835 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Emergacare Po Box 25 Wilson WY 83014-0025 Ph: (307) 733-7835 | Emergacare 190 Mustang Drive Driggs ID 83422-0000 Ph: (307) 733-7835 |
| NPI Number | 1356556518 |
|---|---|
| Provider Enumeration Date | 05/11/2007 |
| Last Update Date | 03/10/2026 |
| Certification Date | 03/10/2026 |
| Medicare PECOS PAC ID | 2466434113 |
|---|---|
| Medicare Enrollment ID | O20040604000956 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1356556518 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 207Q00000X | Family Medicine | () | Primary |
| Provider Name | Brent a Blue |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1063467538 PECOS PAC ID: 2466403886 Enrollment ID: I20100920000271 |
| Provider Name | Duane B Mortenson |
|---|---|
| Provider Type | Practitioner - Physician Assistant |
| Provider Identifiers | NPI Number: 1578848487 PECOS PAC ID: 1850568189 Enrollment ID: I20200603002913 |
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