1275686685 NPI number — KUNA FIRE DEPARTMENT

Table of content: (NPI 1275686685)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1275686685 NPI number — KUNA FIRE DEPARTMENT

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
KUNA FIRE DEPARTMENT
Provider Last Name:
Provider First Name:
Provider Middle Name:
Provider Name Prefix Text:
Provider Name Suffix Text:
Provider Credential Text:
Provider Gender Code:

Provider's Other Name Information

Provider Other Organization Name:
KUNA RURAL FIRE DISTRICT & AMBULANCE SERVICE
Provider Other Organization Name Type Code:
5
Provider Other Last Name:
Provider Other First Name:
Provider Other Middle Name:
Provider Other Name Prefix Text:
Provider Other Name Suffix Text:
Provider Other Credential Text:
Provider Other Last Name Type Code:

NPI Number Information

NPI Number:
1275686685
Entity Type Code:
Organization
Replacement NPI:
Last Update Date:
05/09/2013
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
PO BOX 607
Provider Second Line Business Mailing Address:
Provider Business Mailing Address City Name:
KUNA
Provider Business Mailing Address State Name:
ID
Provider Business Mailing Address Postal Code:
83634-0607
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
208-922-1144
Provider Business Mailing Address Fax Number:
208-922-1135

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
150 W BOISE ST
Provider Second Line Business Practice Location Address:
Provider Business Practice Location Address City Name:
KUNA
Provider Business Practice Location Address State Name:
ID
Provider Business Practice Location Address Postal Code:
83634-0607
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
208-922-1144
Provider Business Practice Location Address Fax Number:
208-922-1135
Provider Enumeration Date:
01/19/2007

Additional Information

Authorized Official

Authorized Official Last Name:
STEAR
Authorized Official First Name:
JOSEPH
Authorized Official Middle Name:
Authorized Official Title or Position:
CHAIRMAN
Authorized Official Telephone Number:
208-922-1144

Provider Taxonomy Codes

  • Taxonomy code: 341600000X , with the licence number:  7403 , registered in the state of ID ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .

Other Provider's Identifiers (legacy, non-NPI)

  • Identifier: 000010014463 . This is a "REGENCE BLUESHIELD OF ID" identifier , issued by the state of ( ID ) . This identifiers is of the category "OTHER".
  • Identifier: E0476 . This is a "BLUE CROSS TRUE BLUE" identifier , issued by the state of ( ID ) . This identifiers is of the category "OTHER".
  • Identifier: 002441700 , issued by the state of ( ID ) . This identifiers is of the category "MEDICAID".
  • Identifier: 70741 . This is a "BLUE SHIELD" identifier , issued by the state of ( ID ) . This identifiers is of the category "OTHER".




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