Organization Name: | CLEARWATER COUNTY DBA BACK COUNTRY MEDICS |
NPI Number: | 1184785248 |
Entity Type Code: | Organizational (2) |
Authorized Official Name: | NICK R ALBERS (ADMINISTRATOR) |
Mailing Address: | 1060 Airport Road Box 586 Orofino |
State: | ID US |
Postal Code: | 835440586 |
Phone Number: | 2084765615 |
Fax Number: | 2084769315 |
NPI Enumeration Date: | 12/13/2006 |
NPI Last Update Date: | 07/23/2013 |
Replacement NPI: | 0 |
NPI Deactivation Date: | |
NPI Reactivation Date: |
Taxonomy Information: | |
Healthcare Provider Taxonomy: | 3416A0800X |
License Number: | 6228 |
Healthcare Provider Taxonomy: (Secondary) | Y |
State: | ID |
Taxonomy Type: | Transportation Services |
Taxonomy Classification: | Ambulance |
Taxonomy Specialization: | Air Transport |
Taxonomy Definition: |