# EAST BOISE COUNTY AMBULANCE DISTRICT

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- **Entity:** Organization
- **Status:** Active
- **Organization subpart:** No

## Provider details

- **NPI number:** 1053801035
- **Authorized official:** ANGELA DILL EMT (DIRECTOR OF OPERTIONS)
- **Authorized official phone:** (208) 392-6644

## Contact information

- **Practice address:** 204 W. COMMERCIAL ST, IDAHO CITY, ID 83631
- **Practice address phone:** (208) 392-6644
- **Practice address fax:** (208) 392-6644
- **Mailing address:** PO BOX 1300, IDAHO CITY, ID 83631-1300
- **Mailing address phone:** (208) 392-6644
- **Mailing address fax:** (208) 392-6644

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 341600000X | Ambulance | 5430 | ID | Yes |

## Other

- **Enumeration date:** 05/15/2018
- **Last updated:** 05/15/2018

## Other identifiers

| Code | Description | Identifier | Issuer | State |
| --- | --- | --- | --- | --- |
| 05 | — | 002807600 | — | ID |