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Organization

KOOTENAI COUNTY EMERGENCY MEDICAL SERVICES SYSTEM

Active
Organization subpart
No

Provider details

NPI number
Authorized official
TRACY R ABRAHAMSON (DIRECTOR OF FINANCE)
(208) 930-4224
Entity
Organization

Contact information

Practice address
4381 W SELTICE WAY, COEUR D ALENE, ID 83814-8910
(208) 930-4224
(208) 930-4259
Mailing address
PO BOX 3510, SILVERDALE, WA 98383-3510
(360) 394-7020
(360) 394-7099

Taxonomy

Speciality
Code
Description
License number
State
341600000X
Ambulance
3416L0300X
Land Ambulance
Primary
8146
ID

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
136705
LABOR & INDUSTRIES
WA
05
299900
OR
01
590013218
RAILROAD MEDICARE PTAN
ID
01
610071400
OWCP
05
805416900
ID
05
9048224
WA
Enumeration date
08/26/2005
Last updated
04/08/2024
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