Organization
LINCOLN COUNTY EMS
Active
Organization subpart
No
Provider details
NPI number
Authorized official
CRESLEY MCCONNELL (CHAIRMAN)
(208) 544-7003
Entity
Organization
Contact information
Practice address
111 W B ST STE C, SHOSHONE, ID 83352-5364
(208) 544-7003
Mailing address
111 W B ST STE C, SHOSHONE, ID 83352-5364
(208) 544-7003
Taxonomy
Speciality
Code
Description
License number
State
3416L0300X
Land Ambulance
Primary
7509
ID
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
807248500
—
ID
Enumeration date
08/30/2006
Last updated
05/09/2017
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