Organization
COUNCIL VALLEY AMBULANCE
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MR. DAN L HUTER EMT (PRESIDENT)
(208) 253-4560
Entity
Organization
Contact information
Practice address
205 N BERKLEY, COUNCIL, ID 83612-0390
(208) 253-4778
(208) 253-4778
Mailing address
205 N BERKLEY, PO BOX 390, COUNCIL, ID 83612-0390
(208) 253-4778
(208) 253-4778
Taxonomy
Speciality
Code
Description
License number
State
341600000X
Ambulance
Primary
5310
ID
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
00010014291
BLUE SHIELD
ID
01
—
E0153
BLUE CROSS
ID
Enumeration date
12/28/2006
Last updated
08/22/2020
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