NPIMap

Organization Active NPI

Clearwater County Dba Back Country Medics

Doing business as Back Country Medics

  • Air Ambulance
  • Orofino, ID
National Provider Identifier
1184785248
Registry record updated Jul 23, 2013
On this page

Key facts

NPPES NPI Registry
Primary specialty
Air AmbulanceTaxonomy code 3416A0800X
License
6228 Issued in ID
Legal business name
CLEARWATER COUNTY DBA BACK COUNTRY MEDICS
Doing business as
Back Country Medics
Practice address
1060 Airport Road
Box 586
Orofino, ID 83544-0586
Phone
(208) 476-5615
Fax
(208) 476-9315
NPI assigned
Dec 13, 2006
Last updated
Jul 23, 2013By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jul 23, 2013

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name
Mr. Nick R Albers
Title
Administrator
Phone
(208) 476-3057

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Air Ambulance 3416A0800X 6228 ID Primary

Addresses

Primary practice location

1060 Airport Road
Box 586
Orofino, ID 83544-0586

Mailing address

PO Box 586
150 Michigan Ave
Orofino, ID 83544-0586
Phone (208) 476-5615

Other identifiers 2

IdentifierTypeStateIssuer
808479400MedicaidID
9062621MedicaidWA

Other names 1

  • Back Country Medics Doing business as

National Provider Directory

National Provider Directory

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1165968000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1374537600000",
    "number": "1184785248",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 586",
            "address_2": "150 MICHIGAN AVE",
            "city": "OROFINO",
            "state": "ID",
            "postal_code": "835440586",
            "telephone_number": "208-476-5615",
            "fax_number": "208-476-9315"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1060 AIRPORT ROAD",
            "address_2": "BOX 586",
            "city": "OROFINO",
            "state": "ID",
            "postal_code": "835440586",
            "telephone_number": "208-476-5615",
            "fax_number": "208-476-9315"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "CLEARWATER COUNTY DBA BACK COUNTRY MEDICS",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-12-13",
        "last_updated": "2013-07-23",
        "status": "A",
        "authorized_official_last_name": "ALBERS",
        "authorized_official_first_name": "NICK",
        "authorized_official_middle_name": "R",
        "authorized_official_title_or_position": "ADMINISTRATOR",
        "authorized_official_telephone_number": "208-476-3057",
        "authorized_official_name_prefix": "Mr."
    },
    "taxonomies": [
        {
            "code": "3416A0800X",
            "taxonomy_group": "",
            "desc": "Ambulance, Air Transport",
            "state": "ID",
            "license": "6228",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "808479400",
            "state": "ID"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "9062621",
            "state": "WA"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Back Country Medics",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Orofino, ID

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 23, 2013; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.