Organization
LEADORE EMERGENCY MEDICAL TECHNICIANS, INC.
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MR. RICHARD SNYDER (PRESIDENT)
(208) 768-2714
Entity
Organization
Contact information
Practice address
117 GALENA ST., LEADORE, ID 83464-0051
(208) 768-2426
(208) 768-2426
Mailing address
PO BOX 51, LEADORE, ID 83464-0051
(208) 768-2426
(208) 768-2426
Taxonomy
Speciality
Code
Description
License number
State
341600000X
Ambulance
Primary
5706
ID
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
000010033120
REGENCE BLUE SHIELD
ID
05
—
002494700
—
ID
05
—
0442323
—
MT
05
—
200070010A
—
OK
01
—
E0682
BLUE CROSS OF IDAHO
ID
Enumeration date
10/12/2006
Last updated
06/09/2009
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