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Organization

COUNTY OF ADA

Active
Other names
Ada County Emergency Medical Services
Organization subpart
No

Provider details

NPI number
Authorized official
MR. TROY M. HAGEN (DIRECTOR)
(208) 287-2965
Entity
Organization

Contact information

Practice address
370 N. BENJAMIN LANE, BOISE, ID 83704
(208) 287-2950
(208) 287-2999
Mailing address
370 N. BENJAMIN LANE, BOISE, ID 83704
(208) 287-2950
(208) 287-2999

Taxonomy

Speciality
Code
Description
License number
State
3416L0300X
Land Ambulance
Primary
8407
ID

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
000010014241
BLUE SHIELD
ID
05
002807200
ID
05
192187
OR
05
9535501
WA
01
E002-1
BLUE CROSS
ID
05
XMTE06322
CA
Enumeration date
05/23/2005
Last updated
05/04/2011
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