MEDICARE: COUNTY OF BOX ELDER

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	3416L0300X	Land Ambulance

General Provider Information

NPI Number	:	1215063060
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	COUNTY OF BOX ELDER

Provider Business Mailing Address
First Line	:	PO BOX 27768
Second Line	:
City	:	SALT LAKE CITY
State	:	UT
Zip	:	84127
Country	:	US
Telephone Number	:	801-972-3600
Fax Number	:

Provider Business Practice Location Address
First Line	:	1 S MAIN ST
Second Line	:
City	:	BRIGHAM CITY
State	:	UT
Zip	:	84302-2548
Country	:	US
Telephone Number	:	435-734-3331
Fax Number	:

Authorized Official
Title or Position	:	EMS DIRECTOR
Name	:	MR. CORY D OAKS
Credential	:	MRP-FPC
Telephone Number	:	801-885-6300

Provider Enumeration Date	:	02/26/2007
Last Update Date	:	11/25/2024

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Directions to “COUNTY OF BOX ELDER ” Practice Location

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