| NPI | 1306984729 |
|---|---|
| Former Legal Business Name | HUMPHREYS DIABETES CENTER INC |
| Entity Type | Organization |
| Authorized Contact | ROBERT SCANLON Executive Director 208-331-1155 |
| Organization Subpart ? | No |
| Primary Taxonomy | 133V00000X Dietitian, Registered |
| Additional Taxonomies | 332B00000X Durable Medical Equipment & Medical Supplies (Licence: ID 4366980001) |
| Enumeration Date | 2007-02-01 |
| Last Update Date | 2011-07-28 |