| NPI | 1174939383 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | SAMUEL H BARKER Sole Member 208-734-0000 |
| Organization Subpart ? | No |
| Primary Taxonomy | 363LF0000X Nurse Practitioner Family |
| Additional Taxonomies | 332B00000X Durable Medical Equipment & Medical Supplies |
| Enumeration Date | 2014-07-08 |
| Last Update Date | 2016-07-11 |