CLARK FORK VALLEY AMBULANCE SERVICE INC. NPI 1841291630

NPI Information

NPI: 1841291630
Provider Name: CLARK FORK VALLEY AMBULANCE SERVICE, INC.
Classification: Ambulance - 3416L0300X
Entity Type: Organization

Specialization: Land Transport

Address:
111 EAST 2ND
CLARK FORK, ID
ZIP 83811
Phone: (208) 266-1161
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CLARK FORK VALLEY AMBULANCE SERVICE, INC. is a land transport ambulance in Clark Fork, ID. CLARK FORK VALLEY AMBULANCE SERVICE, INC. NPI is 1841291630. The provider is registered as an organization entity type.

The provider's business location address is:

111 EAST 2ND
CLARK FORK, ID
ZIP 83811-464
Phone: (208) 266-1161
Fax: (208) 266-0219

The provider's authorized official is Dee Miller .
The authorized official title is Director & Accts Rec'ble Officer and has the following contact phone number (208) 610-3164.

The enumeration date for this NPI number is 8/3/2005 and was last updated on 2/28/2017.

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	6103	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	002459300	MEDICAID	IDAHO
2	1504745	OTHER	IDAHO	PTAN

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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