Provider Demographics
NPI:1720844558
Name:SALMON RIVER AMBULANCE DISTRICT
Entity Type:Organization
Organization Name:SALMON RIVER AMBULANCE DISTRICT
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:DISTRICT CHIEF
Authorized Official - Prefix:
Authorized Official - First Name:CODY
Authorized Official - Middle Name:DEAN
Authorized Official - Last Name:KILLMAR
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:208-983-9263
Mailing Address - Street 1:PO BOX 249
Mailing Address - Street 2:
Mailing Address - City:RIGGINS
Mailing Address - State:ID
Mailing Address - Zip Code:83549-0249
Mailing Address - Country:US
Mailing Address - Phone:208-983-9263
Mailing Address - Fax:
Practice Address - Street 1:116 N MAIN ST
Practice Address - Street 2:
Practice Address - City:RIGGINS
Practice Address - State:ID
Practice Address - Zip Code:83549
Practice Address - Country:US
Practice Address - Phone:208-983-9263
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2024-02-28
Last Update Date:2024-02-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes3416L0300XTransportation ServicesAmbulanceLand Transport