NPIMap

Organization Active NPI

Palisades Bonneville County Rescue

Doing business as Swan Valley Ambulance

  • Land Ambulance
  • Swan Valley, ID
National Provider Identifier
1235323452
Registry record updated Aug 30, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
Land AmbulanceTaxonomy code 3416L0300X
License
5710 Issued in ID
Legal business name
PALISADES BONNEVILLE COUNTY RESCUE
Doing business as
Swan Valley Ambulance
Practice address
Hwy 31 # 15
Swan Valley, ID 83449
Phone
(208) 520-7242
NPI assigned
Aug 30, 2007
Last updated
Aug 30, 2007By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Aug 30, 2007

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

Authorized official

Name
Connie Jacobson
Title
President
Phone
(208) 520-7242

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Land Ambulance 3416L0300X 5710 ID Primary

Addresses

Primary practice location

Hwy 31 # 15
Swan Valley, ID 83449

Mailing address

PO Box 52261
Idaho Falls, ID 83405-2261
Phone (208) 523-4906

Other names 1

  • Swan Valley Ambulance 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": "1188432000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1188432000000",
    "number": "1235323452",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 52261",
            "city": "IDAHO FALLS",
            "state": "ID",
            "postal_code": "834052261",
            "telephone_number": "208-523-4906",
            "fax_number": "208-523-2025"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "HWY 31 # 15",
            "city": "SWAN VALLEY",
            "state": "ID",
            "postal_code": "83449",
            "telephone_number": "208-520-7242"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "PALISADES BONNEVILLE COUNTY RESCUE",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-08-30",
        "last_updated": "2007-08-30",
        "status": "A",
        "authorized_official_last_name": "JACOBSON",
        "authorized_official_first_name": "CONNIE",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "208-520-7242"
    },
    "taxonomies": [
        {
            "code": "3416L0300X",
            "taxonomy_group": "",
            "desc": "Ambulance, Land Transport",
            "state": "ID",
            "license": "5710",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Swan Valley Ambulance",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Swan Valley, ID

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 30, 2007; 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.