Council Valley Ambulance

Primary specialty

AmbulanceTaxonomy code 341600000X

License

5310 Issued in ID

Legal business name

COUNCIL VALLEY AMBULANCE

Practice address

205 N Berkley
Council, ID 83612-0390

Phone

(208) 253-4778

Fax

(208) 253-4778

NPI assigned

Dec 28, 2006

Last updated

Aug 22, 2020By the provider in NPPES

Organization subpart

No

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

Authorized official

Name

Mr. Dan L Huter, EMT

Title

President

Phone

(208) 253-4560

Specialties & licenses 1

Addresses

Other identifiers 2

Medicare fee-for-service enrollment

Enrolled in ID

Enrollment records 1

Locations

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

{
    "created_epoch": "1167264000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1598054400000",
    "number": "1861558868",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "205 N BERKLEY",
            "address_2": "PO BOX 390",
            "city": "COUNCIL",
            "state": "ID",
            "postal_code": "836120390",
            "telephone_number": "208-253-4778",
            "fax_number": "208-253-4778"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "205 N BERKLEY",
            "city": "COUNCIL",
            "state": "ID",
            "postal_code": "836120390",
            "telephone_number": "208-253-4778",
            "fax_number": "208-253-4778"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "COUNCIL VALLEY AMBULANCE",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-12-28",
        "last_updated": "2020-08-22",
        "status": "A",
        "authorized_official_last_name": "HUTER",
        "authorized_official_first_name": "DAN",
        "authorized_official_middle_name": "L",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "208-253-4560",
        "authorized_official_name_prefix": "Mr.",
        "authorized_official_credential": "EMT"
    },
    "taxonomies": [
        {
            "code": "341600000X",
            "taxonomy_group": "",
            "desc": "Ambulance",
            "state": "ID",
            "license": "5310",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BLUE SHIELD",
            "identifier": "00010014291",
            "state": "ID"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BLUE CROSS",
            "identifier": "E0153",
            "state": "ID"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Linda S Bonds Ludwig, LMSW
• Twyla Cairns, LCP
• Jean Pattison Cole, PT
• Council School District
• Council School District No. 13
• Kara Lynn Dillon, RDH EA
• Monte Roscoe Eppich, DDS
• Kristin S Hadley, LMSW
• Andria Lee Hall, MA
• Stacie Marie Hettinga, LCPC

• Ambulance in Council, ID
• Providers in Council, ID by specialty
• Ambulance in Idaho

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 22, 2020; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.