Healthcare Provider Details

I. General information

NPI: 1770788929
Provider Name (Legal Business Name): COUNTY OF ONEIDA
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 06/18/2007
Last Update Date: 01/05/2009
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

10 W COURT ST
MALAD CITY ID
83252-1275
US

IV. Provider business mailing address

PO BOX 44740
BOISE ID
83711-0740
US

V. Phone/Fax

Practice location:
  • Phone: 208-766-4383
  • Fax:
Mailing address:
  • Phone: 208-345-1950
  • Fax: 208-429-6565

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code3416L0300X
TaxonomyLand Ambulance
License Number4610
License Number StateID

VIII. Authorized Official

Name: MRS. KARI D VOGT
Title or Position: OWNER
Credential:
Phone: 208-345-1950