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Organization
ADA BOI INC
Active
Organization
ADA BOI INC
Active
Other names
Ada-Boi Critical Care Transport Service
Organization subpart
No
Provider details
NPI number
Authorized official
MRS. KATHIE S FOGG EMT (OFFICE MANAGER)
(208) 362-2973
Entity
Organization
Contact information
Practice address
7701 W MOSSY CUP ST, BOISE, ID 83709-2844
(208) 362-2973
(208) 362-0854
Mailing address
PO BOX 190480, BOISE, ID 83719-0480
(208) 362-2973
(208) 362-0854
Taxonomy
Speciality
Code
Description
License number
State
341600000X
Ambulance
Primary
8405
ID
3416L0300X
Land Ambulance
8405
ID
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
000010014479
BLUE SHIELD OF IDAHO
ID
05
—
002496600
—
ID
01
—
590157443
RR MEDICARE
ID
01
—
E0419
TRUE BLUE
ID
Enumeration date
01/27/2006
Last updated
05/20/2008
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