CUSTER COUNTY NPI 1487764551

NPI Information

NPI: 1487764551
Provider Name: CUSTER COUNTY

Doing Business As: SOUTH CUSTER AMBULANCE

Classification: Ambulance - 3416L0300X
Entity Type: Organization

Specialization: Land Transport

Address:
202 MCCALEB STREET
MACKAY, ID
ZIP 83251
Phone: (208) 588-2603
Get Directions

CUSTER COUNTY is a land transport ambulance in Mackay, ID. CUSTER COUNTY NPI is 1487764551. The provider is registered as an organization entity type.
The provider Is Doing Business As South Custer Ambulance.

The provider's business location address is:

202 MCCALEB STREET
MACKAY, ID
ZIP 83251
Phone: (208) 588-2603

The provider's authorized official is Wayne Butts .
The authorized official title is Chairman Of The Board Of Custer Cou and has the following contact phone number (208) 879-2360.

The CLIA number assigned to this NPI record is 13D2212951 - ambulance with a certificate type of Certificate of Waiver.

The enumeration date for this NPI number is 8/30/2006 and was last updated on 6/13/2023.

Taxonomy Codes

The NPI record includes the healthcare provider taxonomy classification, state license number and state of licensure. The following information regarding the scope of practice of this provider is available:

No.	Taxonomy Code	Taxonomy Clasification	Taxonomy Specialization	License Number	License State	Primary
1	3416L0300X	Ambulance	Land Transport	7712	IDAHO	Yes

Other Identifiers

The following information regarding additional identifiers associated to this NPI record includes the other identifier number, identifier type, identifier state and issuer.

No.	Other Provider Identifier	Other Provider Identifier Type	Other Provider Identifier State	Other Provider Identifier Issuer
1	002504700	MEDICAID	IDAHO
2	E0609	OTHER	IDAHO	BCBS

What is NPI?

NPI stands for National Provider Identifier. The NPI is a 10-digit identification number that is completely unique. The NPI number by itself does not contain any identifiable information such as a provider’s speciality or location. The NPI is assigned to individuals or organizacions for their lifespan and it is independent of key provider information type updates like a change of practices, location or speciality.

This page was last updated on: 5/5/2024

NPI Synchronization or Removal

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