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Organization

BLAINE COUNTY

Active
Other names
Blaine County Ambulance District
Organization subpart
No

Provider details

NPI number
Authorized official
JOLYNN DRAGE (CLERK, AUDITOR AND RECORDER)
(208) 788-5505
Entity
Organization

Contact information

Practice address
480 E AVENUE N, KETCHUM, ID 83340
(208) 788-5505
Mailing address
206 S 1ST AVE, SUITE 200, HAILEY, ID 83333-8429

Taxonomy

Speciality
Code
Description
License number
State
3416L0300X
Land Ambulance
Primary

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
590014405
RRB
ID
05
805848400
ID
05
805848500
ID
Enumeration date
07/29/2005
Last updated
12/17/2019
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