| NPI | 1013278993 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | ROBERT J LEE Co Manager 208-785-5100 |
| Organization Subpart ? | No |
| Primary Taxonomy | 332B00000X Durable Medical Equipment & Medical Supplies (Licence: ID NO LICENSE REQUIRED) |
| Enumeration Date | 2012-06-06 |
| Last Update Date | 2012-06-06 |