| Organization Name: | COUNTY OF CLARK |
| NPI Number: | 1679791412 |
| Entity Type Code: | Organizational (2) |
| Authorized Official Name: | LISA BLACK (COUNTY CLERK) |
| Mailing Address: | 332 W Main Dubois |
| State: | ID US |
| Postal Code: | 834230205 |
| Phone Number: | 2083745304 |
| Fax Number: | 2083745609 |
| NPI Enumeration Date: | 04/24/2007 |
| NPI Last Update Date: | 08/29/2011 |
| Replacement NPI: | 0 |
| NPI Deactivation Date: | |
| NPI Reactivation Date: |
Taxonomy Information: | |
| Healthcare Provider Taxonomy: | 146M00000X |
| License Number: | |
| Healthcare Provider Taxonomy: (Secondary) | Y |
| State: | ID |
| Taxonomy Type: | Emergency Medical Service Providers |
| Taxonomy Classification: | Emergency Medical Technician, Intermediate |
| Taxonomy Specialization: | |
| Taxonomy Definition: | An Intermediate EMT is an individual trained and certified to perform intermediate life support treatment in medical emergencies based on individual state boards. |