Provider Demographics
NPI:1770788929
Name:COUNTY OF ONEIDA
Entity type:Organization
Organization Name:COUNTY OF ONEIDA
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:MRS
Authorized Official - First Name:KARI
Authorized Official - Middle Name:D
Authorized Official - Last Name:VOGT
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:208-345-1950
Mailing Address - Street 1:PO BOX 44740
Mailing Address - Street 2:
Mailing Address - City:BOISE
Mailing Address - State:ID
Mailing Address - Zip Code:83711-0740
Mailing Address - Country:US
Mailing Address - Phone:208-345-1950
Mailing Address - Fax:208-429-6565
Practice Address - Street 1:10 W COURT ST
Practice Address - Street 2:
Practice Address - City:MALAD CITY
Practice Address - State:ID
Practice Address - Zip Code:83252-1275
Practice Address - Country:US
Practice Address - Phone:208-766-4383
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-06-18
Last Update Date:2009-01-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
ID46103416L0300X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes3416L0300XTransportation ServicesAmbulanceLand Transport
Provider Identifiers
StateIdentifier IDID TypeIssuer
IDE0310OtherBLUE CROSS
ID000010014410OtherBLUE SHIELD
ID002859400Medicaid
IDE0310OtherBLUE CROSS