Clark Fork Valley Ambulance Service, Inc.

LBN: Clark Fork Valley Ambulance Service, Inc.
Clark Fork Valley Ambulance Service, Inc. is an health care organization with primary practice located at 111 East 2Nd , Clark Fork ID 83811-0464. The organization recently has only one registered license in Transportation Services / Land Transport, which is considered as the primary health care specialty. Clark Fork Valley Ambulance Service, Inc. can be contacted via phone (208) 266-1161, or through Miller, Dee via phone (208) 610-3164.

Contact Information

Primary practice address
111 East 2Nd Clark Fork ID 83811-0464
Phone: (208) 266-1161
Fax: (208) 266-0219
Website:
Map and Directions
Authorized official contact:
Name: Miller, Dee
Phone: (208) 610-3164

Health care specialties

SpecialtyCodeLicense #State
Transportation Services / Land Transport 3416L0300X 6103 Idaho

Profile Details

NPI number 1841291630
LBN Legal business name Clark Fork Valley Ambulance Service, Inc.
DBA Doing business as
Authorized official Miller, Dee
Entity Organization
Organization subpart 1 No
Enumeration date Aug 3rd, 2005
Last updated Feb 28th, 2017 - about 7 years ago

1 Some organizations, which are providing health care services, may consist of units or departments that provide different types of health care services or have several separate physical locations, where health care service is provided. These units, departments or physical locations are not themselves legal entities. However, each of them is part of the organization, which is a legal entity. The organization may decide whether its subparts, if it has any, should have their own NPI numbers. In case a subpart conducts any HIPAA standard transactions by itself, without its parent's involvement, it must have its own NPI number.

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Identifiers

StateTypeNumberIssuer
All States NPI 1841291630 NPPES
Idaho Other 1504745 PTAN
Idaho MEDICAID 002459300 PTAN

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