NPI 1053504829

Potlatch Rural Fire Dist

Organisation Land Ambulance Potlatch, ID

Practice location

Address: 512 Pine Street, Potlatch, ID 83855
Phone: (208) 875-0139
Mailing address: PO Box 63, Potlatch, ID 83855-0063

Authorised official

Name: Vivian L Coy
Title: Ambulance Commissioner
Phone: (208) 875-0139

Registered specialties

Land Ambulance Primary

Transportation Services Taxonomy 3416L0300X Licence 7206 (ID)

Other Ambulance providers in Idaho →

Registry record

NPI: 1053504829
Entity type: Organization
NPI issued: 24 Aug 2007
Record last updated: 20 Oct 2009

Reproduced from NPPES, the federal provider registry. The date above is when the provider last updated their own entry, not when we fetched it - a record can be years old and still current in the registry.