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Organization

BOUNDARY VOLUNTEER AMBULANCE SERVICE INC.

Active
Organization subpart
No

Provider details

NPI number
Authorized official
MR. KENNETH V BAKER (CHIEF)
(208) 267-2604
Entity
Organization

Contact information

Practice address
6447 RAILROAD STREET, BONNERS FERRY, ID 83805-6447
(208) 267-2604
(208) 267-9408
Mailing address
PO BOX 441, BONNERS FERRY, ID 83805-0441
(208) 267-2604
(208) 267-9408

Taxonomy

Speciality
Code
Description
License number
State
341600000X
Ambulance
Primary
1500244
ID

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
002645200
ID
01
590161331
PALMETTO GBA - RAILROAD
ID
01
E0443
BLUE CROSS OF IDAHO
ID
Enumeration date
03/16/2007
Last updated
11/08/2018
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