Provider Demographics
NPI:1316003379
Name:BOISE COUNTY
Entity Type:Organization
Organization Name:BOISE COUNTY
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:DEPUTY CLERK EBCAD ACCOUNTS RECEIVA
Authorized Official - Prefix:
Authorized Official - First Name:JILL
Authorized Official - Middle Name:CHERI
Authorized Official - Last Name:BROWNING
Authorized Official - Suffix:
Authorized Official - Credentials:BOISE COUNTY DEPUTY
Authorized Official - Phone:208-392-6066
Mailing Address - Street 1:PO BOX 1300
Mailing Address - Street 2:
Mailing Address - City:IDAHO CITY
Mailing Address - State:ID
Mailing Address - Zip Code:83631
Mailing Address - Country:US
Mailing Address - Phone:208-392-6066
Mailing Address - Fax:208-392-6066
Practice Address - Street 1:BOISE COUNTY OFFICE
Practice Address - Street 2:420 MAIN STREET
Practice Address - City:IDAHO CITY
Practice Address - State:ID
Practice Address - Zip Code:83631
Practice Address - Country:US
Practice Address - Phone:208-392-4431
Practice Address - Fax:208-392-4473
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-12-27
Last Update Date:2012-10-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
ID5430341600000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes341600000XTransportation ServicesAmbulance
Provider Identifiers
StateIdentifier IDID TypeIssuer
ID002807600Medicaid
295878726OtherTRICARE
239843900OtherOWC WORKERS COMP
000010014380OtherBLUE SHIELD
E0732OtherBLUE CROSS
000010014380OtherBLUE SHIELD