| NPI | 1033203146 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | DANIEL SCOTT FUCHS Member 208-735-8700 |
| Organization Subpart ? | No |
| Primary Taxonomy | 332BP3500X Durable Medical Equipment & Medical Supplies Parenteral & Enteral Nutrition (Licence: ID 1333LS) |
| Additional Taxonomies | 3336H0001X Pharmacy Home Infusion Therapy Pharmacy (Licence: ID 1333LS) |
| Enumeration Date | 2006-10-03 |
| Last Update Date | 2008-04-25 |