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Organization

ADA BOI INC

Active
Other names
Ada-Boi Critical Care Transport Service
Organization subpart
No

Provider details

NPI number
Authorized official
MRS. KATHIE S FOGG EMT (OFFICE MANAGER)
(208) 362-2973
Entity
Organization

Contact information

Practice address
7701 W MOSSY CUP ST, BOISE, ID 83709-2844
(208) 362-2973
(208) 362-0854
Mailing address
PO BOX 190480, BOISE, ID 83719-0480
(208) 362-2973
(208) 362-0854

Taxonomy

Speciality
Code
Description
License number
State
341600000X
Ambulance
Primary
8405
ID
3416L0300X
Land Ambulance
8405
ID

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
000010014479
BLUE SHIELD OF IDAHO
ID
05
002496600
ID
01
590157443
RR MEDICARE
ID
01
E0419
TRUE BLUE
ID
Enumeration date
01/27/2006
Last updated
05/20/2008
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