Organization
CLEARWATER COUNTY
Active
Other names
Clearwater County Ambulance
Organization subpart
No
Provider details
NPI number
Authorized official
MR. LES EAVES (DIRECTOR)
(208) 476-3771
Entity
Organization
Contact information
Practice address
1195 RIVERSIDE AVENUE, OROFINO, ID 83544
(208) 476-3771
(208) 476-3155
Mailing address
PO BOX 1347, OROFINO, ID 83544-1347
(208) 476-3771
(208) 476-3155
Taxonomy
Speciality
Code
Description
License number
State
3416L0300X
Land Ambulance
Primary
7219
ID
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
000010014651
REGENCE
ID
05
—
002808400
—
ID
01
—
191027
REGENCE NORTHWEST HEALTH
ID
01
—
756590508
RAILROAD MEDICARE
ID
01
—
E0690
BLUE CROSS OF IDAHO
ID
Enumeration date
09/05/2006
Last updated
04/18/2014
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