Organization
COUNTY OF ADA
Active
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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