Provider Demographics
NPI:1811916984
Name:CITY OF HORSESHOE BEND
Entity type:Organization
Organization Name:CITY OF HORSESHOE BEND
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:TREASURER
Authorized Official - Prefix:
Authorized Official - First Name:GINA
Authorized Official - Middle Name:
Authorized Official - Last Name:ELMER
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:208-793-2219
Mailing Address - Street 1:PO BOX 246
Mailing Address - Street 2:
Mailing Address - City:HORSESHOE BEND
Mailing Address - State:ID
Mailing Address - Zip Code:83629-0246
Mailing Address - Country:US
Mailing Address - Phone:208-793-2219
Mailing Address - Fax:208-793-2403
Practice Address - Street 1:112 ADAMS STREET
Practice Address - Street 2:
Practice Address - City:HORSESHOE BEND
Practice Address - State:ID
Practice Address - Zip Code:83629-0246
Practice Address - Country:US
Practice Address - Phone:208-793-2219
Practice Address - Fax:208-793-2403
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-07-19
Last Update Date:2025-04-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
ID54023416L0300X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes3416L0300XTransportation ServicesAmbulanceLand Transport
Provider Identifiers
StateIdentifier IDID TypeIssuer
ID000010014267OtherREGENCE BLUE SHIELD OF ID
ID0028595Medicaid
IDE0468OtherBLUE CROSS
ID590014035OtherRAILROAD MEDICARE
ID1500822Medicare PIN