| NPI | 1457810822 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | MORGANA SAMORA Manager 208-929-2234 |
| Organization Subpart ? | No |
| Primary Taxonomy | 332B00000X Durable Medical Equipment & Medical Supplies |
| Additional Taxonomies | 332BX2000X Durable Medical Equipment & Medical Supplies, Oxygen Equipment & Supplies |
| Enumeration Date | 2019-03-15 |
| Last Update Date | 2019-06-11 |