Provider Demographics
NPI:1558372847
Name:COUNTY OF LEMHI
Entity Type:Organization
Organization Name:COUNTY OF LEMHI
Other - Org Name:LEMHI COUNTY AMBULANCE
Other - Org Type:Doing Business As
Authorized Official - Title/Position:INSURANCE CLERK
Authorized Official - Prefix:
Authorized Official - First Name:BRENDA
Authorized Official - Middle Name:
Authorized Official - Last Name:ARMSTRONG
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:208-756-2815
Mailing Address - Street 1:206 COURTHOUSE DR
Mailing Address - Street 2:
Mailing Address - City:SALMON
Mailing Address - State:ID
Mailing Address - Zip Code:83467-3900
Mailing Address - Country:US
Mailing Address - Phone:208-756-2815
Mailing Address - Fax:208-756-8424
Practice Address - Street 1:206 COURTHOUSE DR
Practice Address - Street 2:
Practice Address - City:SALMON
Practice Address - State:ID
Practice Address - Zip Code:83467-3900
Practice Address - Country:US
Practice Address - Phone:208-756-2815
Practice Address - Fax:208-756-8424
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:COUNTY OF LEMHI
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2006-08-11
Last Update Date:2009-12-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes3416L0300XTransportation ServicesAmbulanceLand Transport
Provider Identifiers
StateIdentifier IDID TypeIssuer
IDE0245OtherBLUE CROSS
ID002809700Medicaid
ID1505313Medicare UPIN