| NPI | 1225365992 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | JERRY D. COOPER Owner 208-523-2928 |
| Organization Subpart ? | No |
| Primary Taxonomy | 332B00000X Durable Medical Equipment & Medical Supplies (Licence: ID P126) |
| Enumeration Date | 2009-11-17 |
| Last Update Date | 2009-11-17 |