| NPI | 1053582197 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | DENISE C MCCLURE Executive Director 208-463-5549 |
| Organization Subpart ? | No |
| Primary Taxonomy | 332B00000X Durable Medical Equipment & Medical Supplies |
| Enumeration Date | 2008-03-17 |
| Last Update Date | 2008-03-17 |