Organization
COUNTY OF GEM
Active
Other names
GEM COUNTY AMBULANCE
Organization subpart
No
Provider details
NPI number
Authorized official
JEANIE EDITH M. HARRIS NREMT-I (DEPUTY EMT- BILLING)
(208) 365-3684
Entity
Organization
Contact information
Practice address
330 E MAIN ST, EMMETT, ID 83617-3034
(208) 365-3684
(208) 365-3683
Mailing address
415 E MAIN ST, RM. 202, EMMETT, ID 83617-3059
(208) 365-3684
(208) 365-3683
Taxonomy
Speciality
Code
Description
License number
State
3416L0300X
Land Ambulance
Primary
7306
ID
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
000010015165
BLUE SHIELD
ID
01
—
1500010
MEDICARE ID - TYPE UNSPEC
ID
01
—
275436
OMAP
ID
01
—
E019-5
BLUE CROSS
ID
Enumeration date
08/03/2006
Last updated
11/21/2007
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