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General NPI Number Information
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NPI Number | 1023393709
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Entity Type | Organization
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Legal Business Name | CITY OF TROY
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Dates
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Enumeration Date | 10/13/2011
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Last Update Date | 10/13/2011
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Provider Practice Location Address
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Address Line | 521 EAGLE ALLEY
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City | TROY
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State | ID
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Zip | 83871
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Country | US
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Telephone | 208-596-6384
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Fax |
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Provider Business Mailing Address
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Address Line | PO BOX 324
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City | TROY
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State | ID
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Zip | 83871
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Country | US
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Telephone | 208-596-6384
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Fax |
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Authorized Official
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Title or Position | DIRECTOR
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Name | DONNA OPESIK
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Credential |
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Telephone | 208-596-6384
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 3416L0300X
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Taxonomy Name | Land Ambulance
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License Number | 12345
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License Number State | ID
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