MEDICARE: BOISE COUNTY

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	341600000X	Ambulance	5430	ID

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier Issuer
1	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program
2	295878726	OTHER	TRICARE
3	239843900	OTHER	OWC WORKERS COMP
4	000010014380	OTHER	BLUE SHIELD
5	E0732	OTHER	BLUE CROSS

General Provider Information

NPI Number	:	1316003379
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	BOISE COUNTY

Provider Business Mailing Address
First Line	:	PO BOX 1300
Second Line	:
City	:	IDAHO CITY
State	:	ID
Zip	:	83631
Country	:	US
Telephone Number	:	208-392-6066
Fax Number	:	208-392-6066

Provider Business Practice Location Address
First Line	:	BOISE COUNTY OFFICE
Second Line	:	420 MAIN STREET
City	:	IDAHO CITY
State	:	ID
Zip	:	83631
Country	:	US
Telephone Number	:	208-392-4431
Fax Number	:	208-392-4473

Authorized Official
Title or Position	:	DEPUTY CLERK EBCAD ACCOUNTS RECEIVA
Name	:	JILL CHERI BROWNING
Credential	:	BOISE COUNTY DEPUTY
Telephone Number	:	208-392-6066

Provider Enumeration Date	:	12/27/2006
Last Update Date	:	10/24/2012

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Directions to “BOISE COUNTY ” Practice Location

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